Thrombotic thrombocytopenic purpura as the cause of death in an HIV-positive child.

A case of fatal thrombotic thrombocytopenic purpura (TTP) in a pediatric patients with HIV infection is reported. The diagnosis was made at autopsy based on the presence of platelet microthrombi in multiple organs, including the cardiac conduction system. The disease presented atypically with hemorrhagic manifestations, thrombocytopenia, and hemolytic anemia, without significant accompanying neurologic and renal abnormalities. Autoimmune-based thrombocytopenia has been well documented in the presence of HIV infection in both the adult and the pediatric population. We believe this to be the first reported case of TTP in an HIV-positive child.