Atypical Presentation of Thrombotic Thrombocytopenic Purpura: A Rare Entity

CHEST Journal ◽  
2011 ◽  
Vol 140 (4) ◽  
pp. 137A
Author(s):  
Riffat Meraj ◽  
Peter Lenz
Keyword(s):  
Thrombotic Thrombocytopenic Purpura ◽  
Atypical Presentation ◽  
Rare Entity ◽  
Thrombocytopenic Purpura

scholarly journals Thrombotic Thrombocytopenic Purpura: A Case Presenting with Acute Ischemic Colitis

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Joseph R. H. See ◽  
Tarek Sabagh ◽  
Christopher J. Barde
Keyword(s):  
Case Report ◽  
Renal Disease ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Hemolytic Anemia ◽  
Ischemic Colitis ◽  
Disease Process ◽  
Good Prognosis ◽  
Atypical Presentation ◽  
Thrombocytopenic Purpura

Thrombotic thrombocytopenic purpura (TTP) consists of the pentad of thrombocytopenia, hemolytic anemia, fever, neurologic abnormalities, and renal disease. We present a case report of acute TTP following a bout of ischemic colitis. This report reminds the clinician that ischemic colitis can be an atypical presentation of TTP. The prompt recognition and treatment of this disease process resulted in a good prognosis for our patient.

scholarly journals Atypical Thrombotic Thrombocytopenic Purpura Presenting as Stroke

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Pradeepthi Badugu ◽  
Modupe Idowu
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Thrombus Formation ◽  
Peripheral Blood Smear ◽  
Clinical Findings ◽  
First Episode ◽  
Atypical Presentation ◽  
Thrombocytopenic Purpura

Here we report a case of atypical thrombotic thrombocytopenic purpura that presented as an ischemic cerebrovascular accident. A 56-year-old man with multiple cardiovascular risk factors presented with sudden left-sided weakness, slurred speech, and left facial droop. He showed mild improvement when he was treated with thrombolytic therapy according to the hospital stroke protocol. Later in the course, he developed thrombocytopenia followed by schistocytes revealed by peripheral blood smear and other lab abnormalities. Thrombotic thrombocytopenic purpura (TTP) was suspected, and he was treated with total plasma exchange that improved his condition significantly. This case shows that TTP can have unusual and atypical presentations either with the first episode or upon relapse, making diagnosis extremely difficult. Because patients may not present the expected clinical findings, it is important to be aware of variant presentations. In the early stages of the disease, platelet aggregation and thrombus formation may not be widespread, and thrombocytopenia and microangiopathic hemolytic anemia may not be clinically evident. Patients can present soon after the onset of symptoms when the typical laboratory abnormalities may not have had ample time to manifest. Although most other similar cases in the literature had a previous typical presentation of the disease before an atypical presentation, our patient’s first presentation was atypical. An atypical presentation of disease in a patient with cardiovascular risk factors may therefore be extremely difficult to diagnose. We believe that TTP should be considered for any patient presenting with stroke and thrombocytopenia.

scholarly journals What Are Appropriate Initial and Salvage Therapies for Patients with Thrombotic Thrombocyopenic Purpura (TTP)?

2004 ◽  
Vol 47 (1) ◽  
pp. 59-60
Author(s):  
Leo McCarthy ◽  
Atillio Orazi ◽  
Charles Miraglia ◽  
Daniel Waxman ◽  
Elaine Skipworth ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Plasma Exchange ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Controlled Trials ◽  
Evidence Based ◽  
Rare Entity ◽  
Thrombocytopenic Purpura ◽  
Randomized Controlled ◽  
Initial Description

Although much has been learned about the pathophysiologic process of thrombotic thrombocytopenic purpura (TTP), both diagnostically and therapeutically, since its initial description by Moschowitz in 1924, its etiology and treatments remain, in many instances, problematic. Thrombotic thrombocytopenic purpura remains a rare entity whose etiology is usually unknown, but several drugs and infections have now been implicated in its development. Although treatment by plasma exchange has gained worldwide acceptance, the optimal exchange media is not known, nor the volume and duration of exchange therapy, not appropriate salvage therapies. Without the benefit of randomized controlled trials, its treatment, to a large extent, remains not evidence-based but “eminence-based“, making the same mistakes with increasing confidence over decades.

scholarly journals Atypical Presentation of Thrombotic Thrombocytopenic Purpura without Hematological Features

2020 ◽  
Author(s):  
Balraj Singh ◽  
Kok Hoe Chan ◽  
Parminder Kaur ◽  
Varun Modi ◽  
Michael Maroules
Keyword(s):  
Thrombotic Thrombocytopenic Purpura ◽  
Neurological Dysfunction ◽  
Thrombotic Complication ◽  
Atypical Presentation ◽  
Thrombocytopenic Purpura ◽  
Severe Deficiency ◽  
Life Threatening ◽  
Neurological Features ◽  
High Index Of Suspicion ◽  
Von Willebrand

Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disease, usually diagnosed with high index of suspicion. The pathophysiology of TTP is due to severe deficiency of von Willebrand factor cleaving protease, known as ADAMTS 13. Early diagnosis is crucial as without treatment TTP is associated with high mortality rate. Plasma exchange is currently the mainstay of treatment. Nonetheless, the classical pentad of microangiopathic hemolytic anemia (MAHA), thrombocytopenia, neurological dysfunction, kidney dysfunction and fever are seen only in 40 percent of the patients. MAHA and thrombocytopenia are the common presenting features. Presentation with thrombotic complication without hematological features (MAHA and thrombocytopenia) is rare and makes the diagnosis difficult. Herein, we report an unusual presentation of a 53-year-old male, who was initially presented in 2014 with classical features of TTP, however had an atypical presentation of TTP in 2016 with only neurological features without hematological features.

scholarly journals A Case of Thrombotic Thrombocytopenic Purpura without Pathognomonic Schistocytes

2021 ◽  
Vol 11 (2) ◽  
pp. 223-227
Author(s):  
Kevin Yu ◽  
Min Yan
Keyword(s):  
Thrombotic Thrombocytopenic Purpura ◽  
Blood Smear ◽  
Clinical Manifestations ◽  
Atypical Presentation ◽  
Thrombocytopenic Purpura ◽  
Activity Awareness ◽  
A Disintegrin And Metalloproteinase ◽  
Timely Treatment ◽  
Blood Smear Review

Patients diagnosed with thrombotic thrombocytopenic purpura (TTP) typically present with microangiopathic hemolytic anemia (MAHA) and thrombocytopenia; these two clinical manifestations were often believed to be essential indicators of TTP. However, such indicators are not always present in every case. Here, we present a patient affected by TTP but showing no distinctive schistocytes on blood smear review. TTP was diagnosed through a critically low level of a disintegrin and metalloproteinase with thrombospondin type 1 motif, member 13 (ADAMTS13) activity. Awareness of such an atypical presentation of TTP is essential for timely treatment to prevent serious and even fatal outcomes for patients.

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