The features of acquired thrombotic thrombocytopenic purpura occurring at advanced age

The clinical picture of thrombotic microangiopathy in patients older than 60 years of age

“…[1][2][3][4] MCD is associated with human herpesvirus-8 (HHV-8) infection in immunocompromised patients. However, MCD is unrelated to HHV-8 in up to 50% of patients 5 ; this disease entity is known as HHV8-negative or idiopathic MCD (iMCD). Interleukin (IL)-6 plays a central role in the pathogenesis of iMCD, with multiple proinflammatory effects.…”

“…Patients over 60 years of age seem to be at higher risk of mortality and complications, 3,4 as borne out in recent, dedicated studies focusing on elderly-onset TTP. 5,6 However, data concerning all TMA subtypes are lacking.…”

“…Some of these results are similar to those described in older patients with TTP. 5,6 At onset, gastro-intestinal bleeding also occurs more often among older patients, suggesting a larger proportion of patients with pre-existing gastro-intestinal lesions. Moreover, these events can be challenging in the context of potential TMA-targeted therapies increasing the risk of haemorrhage (such as caplacizumab), and venous thromboembolism prevention management.…”

“…Within our cohort, ICU mortality was consistent with the rest of the literature. [3][4][5][6] The more frequent requirement for RRT and the higher ICU mortality among older patients could be explained by the higher rate of comorbidities and resulting frailty. The delayed diagnosis of TMA due to atypical features may also account for this difference, as well as the higher rate of cancer-related TMA, most of the time beyond all therapeutic resource.…”

Епидемиология На Придобитата Тромботична Тромбоцитопенична Пурпура

“…Поради тази причина в миналото заболяването се е класифицирало в множество ръководства като ТТП/ХУС синдром. Отделно няколко ретроспективни анализа откриват пациенти с ТТП, класифицирани като атипичен ХУС [15]. Към момента ТТП е класифицирана от последното издание на Международната класификация на болестите (МКБ-10) в групата на васкулопатиите с код М31.1, като заболяването е означено и като рядко с идентификатор в Orphanet OR-PHA93585.…”