Acute thrombotic thrombocytopenic purpura and cholecystitis.

Acute thrombotic thrombocytopenic purpura (TTP) is a rare, usually fatal, disease characterized by widespread deposition of microvascular occlusive thrombi of platelets and fibrin. Although its exact etiology is unknown, numerous case reports in the medical literature have linked TTP with a variety of medical conditions, including systemic infections, vaccinations, pregnancy, and autoimmune diseases. A case of acute TTP occurring in a 28-year-old white male is presented and discussed, with emphasis on emergency department diagnosis and management. This patient's treatment included splenectomy. When laparotomy was performed for this procedure, the patient was found to have a distended, inflamed gallbladder, and a cholecystectomy was also performed. A review of the medical literature reveals this to be the first reported case of TTP occurring in association with cholecystitis.