TTP

 

Overview:

  1. Age onset is 10-40 y.o.
     
  2. History of recent infection, drug use, family history

S & S:

  1. plt, microangiopathic hemolysis, neurological signs, fever, renal  failure. All the symptoms generally   must be present to assume diagnosis.
     
  2. Purpura in pressure areas, patechiae, ecchymosis

DX:

  1. Fragmented  RBCs on peripheral smear, reticulocites, LDH, jaundice (2ry to hemolysis), absence of  DIC  findings.
     
  2. HUS closely resembles TTP but renal findings are predominate and no CNS symptoms.
     
  3. Check fundi especially if pt c/o of visual disturbance.

Therapy:

  1. FFP 2U q6hrs until plt count increases to 20,000 - 100,000/mm3.
  2. Immunoglobulin IV
     
  3. Plasmapheresis.
     
  4. Plt transfusion is not indicated.
     
  5. Vincristine

 

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