Thrombotic thrombocytopenic purpura occurring in the puerperium has not been described previously in the literature. For this reason and the fact that there was an associated selective pancreatic islet-cell necrosis which presented initially as a surgical problem, it is reported at this time.

The disease was first described by Moschowitz,¹ in 1925, and to date approximately 70 cases have been published in the literature under various names, including generalized platelet thrombosis,² thrombocytic achroangiothrombosis,³ and thrombocytopenic verrucal angionecrosis.⁴

Thrombotic thrombocytopenic purpura is an acute fatal disease of unknown etiology characterized clinically by the deficiency of platelets, hemolytic anemia, neurologic findings, and a low-grade fever. The diagnostic pathological feature is the presence of numerous occlusive mound-like lesions in the arterioles and capillaries of most internal organs, particularly the heart, adrenal, and pancreas.

Originally there was thought to be a female sex predominance,³ but this has not been