Signs and symptoms of aTTP


The symptoms of aTTP are driven by microthrombi, which are unpredictable and potentially fatal1,2

Microthrombi can have serious acute and chronic consequences in TTP—putting patients at risk for devastating effects and death without urgent treatment.

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Microthrombi can occur in any organ with microvessels, but the most commonly affected are3

Microthrombi can occur in any organ with microvessels, but the most commonly affected are the brain, heart, kidneys, spleen, pancreas, and adrenals

Tissue and organ damage resulting from ischemia leads to increased levels of lactate dehydrogenase (LDH), troponins (heart), and creatinine (kidney).1,4

Dr Spero Cataland

Experts explain TTP pathogenesis

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Dr Maria Scully

The signs and symptoms of TTP

Dr Marie Scully details the variable, complex signs and symptoms of TTP.
 

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Dr Flora Peyvandi

TTP patient case study

Dr Flora Peyvandi shares her experience with a 24-year-old female patient, underscoring the urgency and severe consequences of TTP when signs go unnoticed.

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Signs and symptoms of acquired thrombotic thrombocytopenic purpura (aTTP) include1,4,5

Petechiae, Purpura, Bruising
Petechiae, purpura, bruising (skin)

headaches, confusion, seizure, coma (neurological)
Headache, confusion, seizures, coma (neurological)

EKG Abnormalities (Cardiac)
EKG abnormalities (cardiac)

Abdominal Pain, diarrhea (gastrointestinal)
Abdominal pain, diarrhea (gastrointestinal)

Proteinuria/Hematuria (Kidney)
Proteinuria/hematuria (kidney)

Up to 70% of TTP episodes result in ischemia due to platelet aggregation in the microcirculation of the brain

of TTP episodes result in ischemia due to platelet aggregation in the microcirculation of the brain.3

The consequences of microthrombi can be severe, with TTP potentially resulting in acute thromboembolic events such as1,2,4

The consequences of microthrombi can be severe, with TTP potentially resulting in acute thromboembolic events such as Stroke

Stroke

The consequences of microthrombi can be severe, with TTP potentially resulting in acute thromboembolic events such as Myocardial infarction

Myocardial infarction

The consequences of microthrombi can be severe, with TTP potentially resulting in acute thromboembolic events such as venous thrombosis.

Arterial thrombosis

The consequences of microthrombi can be severe, with TTP potentially resulting in acute thromboembolic events such as venous thrombosis. The consequences of microthrombi can be severe, with TTP potentially resulting in acute thromboembolic events such as early death.

Early death

Consequences can also be long term

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Rapid recognition of aTTP is critical to outcomes.

How to diagnose

Long-term risks of TTP can be life-altering for patients. Thinking beyond the acute stages is imperative.

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EKG=electrocardiogram.

References: 1. Joly BS, Coppo P, Veyradier A. Thrombotic thrombocytopenic purpura. Blood. 2017;129(21):2836-2846. doi:10.1182/blood-2016-10-709857 2. Goel R, King KE, Takemoto CM, Ness PM, Tobian AAR. Prognostic risk-stratified score for predicting mortality in hospitalized patients with thrombotic thrombocytopenic purpura: nationally representative data from 2007 to 2012. Transfusion. 2016;56(6):1451-1458. doi:10.1111/trf.13586 3. Moake JL. Thrombotic thrombocytopenic purpura: the systemic clumping “plague.” Annu Rev Med. 2002;53:75-88. doi:10.1146/annurev.med.53.082901.103948 4. Scully M, Hunt BJ, Benjamin S, et al; British Committee for Standards in Haematology. Guidelines on the diagnosis and management of thrombotic thrombocytopenic purpura and other thrombotic microangiopathies. Br J Haematol. 2012;158(3):323-335. doi:10.1111/j.1365-2141.2012.09167.x 5. Azoulay E, Bauer PR, Mariotte E, et al; Nine-i Investigators. Expert statement on the ICU management of patients with thrombotic thrombocytopenic purpura. Intensive Care Med. 2019;45(11):1518-1539. doi:10.1007/s00134-019-05736-5