Thrombotic thrombocytopenic purpura–hemolytic uremic syndrome
(TTP–HUS) is an uncommon but serious illness that can cause
death. In TTP–HUS, several organs (kidney, brain) get clogged
with fragments of red blood cells and platelets. Red cells are
broken down faster than they can be replaced (hemolytic anemia).
Blood-clotting cells called platelets are reduced
(thrombocytopenia) because they get stuck in the areas
containing red blood cell fragments. Abnormal clotting or
thrombosis results in many parts of the body. Symptoms include
confusion, kidney failure, and increased bruising (purpura).
Immediate treatment with exchange of plasma (blood fluid without
blood cells) prevents death in most patients. This disorder may
be caused by an abnormal immune reaction (to a drug or other
agent), in which the body produces antibodies that attack many
cell types. Quinine, a drug used to treat leg cramps and
available in nutrition stores, is the most common cause of drug-
related TTP–HUS. The course and outcomes of quinine