From the Research
Thrombotic Thrombocytopenic Purpura (TTP) typically presents with a pentad of clinical features, including microangiopathic hemolytic anemia, thrombocytopenia, neurological abnormalities, renal dysfunction, and fever, although not all features may be present in every case, as noted in a recent case report 1. The classic pentad of TTP includes:
- Microangiopathic hemolytic anemia
- Thrombocytopenia
- Neurological abnormalities
- Renal dysfunction
- Fever Patients often present with petechiae, purpura, or easy bruising due to severe thrombocytopenia (platelet count usually <30,000/μL) 2. Neurological manifestations can range from headache, confusion, and altered mental status to seizures, focal deficits, and coma, as highlighted in a case report where TTP presented as a complex migraine 1. Renal involvement typically manifests as hematuria, proteinuria, or acute kidney injury, and may be the primary presenting feature in some cases, challenging the traditional pentad-based diagnosis 3. Laboratory findings include schistocytes (fragmented red blood cells) on peripheral blood smear, elevated lactate dehydrogenase (LDH), decreased haptoglobin, and negative direct Coombs test 2. The diagnosis of TTP is crucial and should be considered in patients with atypical presentations, as delayed treatment can lead to high mortality rates, emphasizing the importance of prompt recognition and initiation of therapeutic plasma exchange 4.