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Plasma cytokine levels in thrombotic thrombocytopenic purpura

Plasma cytokine levels were examined in 13 patients with thrombotic thrombocytopenic purpura (TTP). Auto‐antibodies, platelet‐associated immunoglobulin G, and platelet aggregating factor were detected in many of these patients and high‐molecular‐weight bands of von Willebrand factor multimers were reduced in 9 of 10 patients examined. Complete remission (CR) was attained in 7 of the 13 patients, but 6 died. Tumor necrosis factor (TNF), Interleukin (IL)‐1β, IL‐6, and soluble IL‐2 receptor showed marked increases at onset and decreased at CR. The prognosis tended to be poor in patients with increased IL‐6 and soluble IL‐2 receptor levels. These findings suggest that immunological mechanisms, such as the activation of macrophage, are involved in the pathogenesis of TTP and are reflected in the plasma cytokine levels. © 1992 Wiley‐Liss, Inc.