• Martine Szyper Kravitz and Yehuda Shoenfeld.
• Center for Autoimmune Diseases and Department of Medicine B, Chaim Sheba Medical Center Tel-Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Israel.
• Am. J. Hematol. 2005 Nov 1; 80 (3): 232-42.

AbstractImmune thrombocytopenia purpura (ITP), thrombotic thrombocytopenia purpura (TTP), heparin-induced thrombocytopenia (HIT), and antiphospholipid syndrome (APS) are clinical conditions associated with significant morbidity and mortality. These well-defined clinical syndromes have in common several properties: (1) their pathogenesis is immune mediated, specifically by autoantibodies; (2) thrombocytopenia is a hallmark in these four conditions; (3) except for the case of ITP, platelet and endothelial cell activation occurs in TTP, HIT, and APS, resulting in a prothrombotic state and an increased risk of thrombosis. Although these four immune-mediated syndromes are well-defined diseases, several case reports and studies have documented the association of two diseases in the same patient, illustrating the concept of the kaleidoscope of autoimmunity.

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