Thrombotic Thrombocytopenic Purpura (TTP)

Abstract

Thrombotic thrombocytopenic purpura is a medical emergency with varied clinical manifestations. TTP is a rare condition, but one that carries a high mortality. High index of suspicion with careful evaluation of thrombocytopenia and hemolytic anemia is of paramount importance. Symptoms result from microthrombi affecting microcirculation and can be varied depending on the organs involved. Laboratory parameters of microangiopathic hemolytic anemia i.e. schitocytosis and increased LDH and indirect hyperbilirubinemia support the diagnosis. Plasma exchange is the treatment of choice. Other modalities that may provide therapeutic benefit in cases of relapsing TTP or in patients with slow or partial response to plasma exchange include vincristine and rituximab. Splenectomy done in remission may decrease recurrence in patients with relapsing TTP.