TTP


Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disease that requires prompt diagnosis and immediate treatment. This interactive algorithm will guide you through all the key steps - from the first symptoms, especially neurological, through differential diagnosis and evaluation of laboratory findings, to the choice of acute therapy, management of complications and identifying the underlying cause. TTP is a rare disease, but its early recognition is essential. Only those who know the diagnosis can make the right decision - and thanks to our algorithm, that could be you!

2025
Thrombosis
Thrombocytopenia
Plasmapheresis
Stroke
Caplacizumab
Hypocalcaemia
Anemia
Hemolysis
Published at: 4.9.2025

Review

Sources

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AKSAY, E. Thrombotic thrombocytopenic purpura mimicking acute ischemic stroke [online]. Emergency Medicine Journal. 2006, vol. 23, no. 9, pp. e51-e51. ISSN 1472-0205. Available from: https://doi.org/10.1136/emj.2006.036327 [cited 2024-11-12].

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https://mzd.gov.cz/wp-content/uploads/2021/08/Metodick%c3%bd-pokyn-p%c3%a9%c4%8de-o-pacienty-s-CMP.pdf

DOPSON, Shirley J. a ULLIAN, Michael E. Proteinuria in Patients with Thrombotic Thrombocytopenic Purpura. Online. Nephrology Research & Reviews. 2011, vol. 3, iss. 1, p. 1-4. ISSN 2035-813X. Available at: https://doi.org/10.4081/nr.2011.e1. [cited 2024-11-12].

DYLLA, Layne; ADLER, David H.; ABAR, Beau; BENESCH, Curtis; JONES, Courtney M.C. et al. Prehospital supplemental oxygen for acute stroke – A retrospective analysis. Online. The American Journal of Emergency Medicine. 2020, vol. 38, iss. 11, p. 2324-2328. ISSN 07356757. Available at: https://doi.org/10.1016/j.ajem.2019.11.002. [cited 2024-11-12].

Intensive versus Conventional Glucose Control in Critically Ill Patients. Online. New England Journal of Medicine. 2009, vol. 360, iss. 13, p. 1283-1297. ISSN 0028-4793. Available at: https://doi.org/10.1056/NEJMoa0810625. [cited 2024-11-13].

 

SPOKOYNY, Ilana; RAMAN, Rema; ERNSTROM, Karin; MEYER, Brett C. a HEMMEN, Thomas M. Imaging Negative Stroke: Diagnoses and Outcomes in Intravenous Tissue Plasminogen Activator–Treated Patients. Online. Journal of Stroke and Cerebrovascular Diseases. 2014, vol. 23, iss. 5, p. 1046-1050. ISSN 10523057. Available at: https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.08.023. [cited 2024-11-14].

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FIEBACH, J.B.; SCHELLINGER, P.D.; JANSEN, O.; MEYER, M.; WILDE, P. et al. CT and Diffusion-Weighted MR Imaging in Randomized Order. Online. Stroke. 2002, vol. 33, iss. 9, p. 2206-2210. ISSN 0039-2499. Available at: https://doi.org/10.1161/01.STR.0000026864.20339.CB. [cited 2024-11-15].

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Learning targets

1. The student is aware of the clinical signs and laboratory abnormalities typical of TTP.
2. The student can recognize TTP as an acute, life-threatening condition and knows the principles of early diagnosis and differential diagnosis.
3. The student knows the management and treatment of the patient with TTP and understands the contraindications to certain procedures that may worsen the course of the disease or endanger the patient's life.

Key points

1. TTP is a rare and life-threatening disease characterised by a pentad of symptoms: microangiopathic haemolytic anaemia, thrombocytopenia, neurological symptoms, fever and renal failure
2. It is caused by a deficiency of the enzyme ADAMTS13, leading to the formation of microthrombi
3. When TTP is suspected, it is essential not to administer platelet transfusion products and to transport the patient immediately to a hematology care center
4. Treatment includes plasmapheresis, corticosteroids and caplacizumab

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