Thrombotic thrombocytopenic purpura history and symptoms: Difference between revisions

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{{Thrombotic thrombocytopenic purpura}}
{{Thrombotic thrombocytopenic purpura}}
{{CMG}}
 
{{CMG}} {{shyam}}; {{AE}} {{S.G.}}
==Overview==
==Overview==
The majority of patients with TTP are asymptomatic. However, the classic pentad of signs/symptoms includes microangiopathic hemolytic anemia, renal failure, thrombocytopenia, neurologic dysfunction, and fever.
==History and Symptoms==
==History and Symptoms==
* History of autoimmune disease like SLE
===History===
* History of surgery or transplant
*[[Patient|Patients]] with TTP may have a positive history of:<ref name="pmid22624596">{{cite journal |vauthors=Scully M, Hunt BJ, Benjamin S, Liesner R, Rose P, Peyvandi F, Cheung B, Machin SJ |title=Guidelines on the diagnosis and management of thrombotic thrombocytopenic purpura and other thrombotic microangiopathies |journal=Br. J. Haematol. |volume=158 |issue=3 |pages=323–35 |date=August 2012 |pmid=22624596 |doi=10.1111/j.1365-2141.2012.09167.x |url=}}</ref>
* Drug history  
 
* Initial symptoms: Fatigue, pale and/or red skin, shortness of breath, bruises, bleeding <ref name="pmid23294213">{{cite journal| author=Griffin D, Al-Nouri ZL, Muthurajah D, Ross JR, Ballard RB, Terrell DR et al.| title=First symptoms in patients with thrombotic thrombocytopenic purpura: what are they and when do they occur? | journal=Transfusion | year= 2013 | volume= 53 | issue= 1 | pages= 235-7 | pmid=23294213 | doi=10.1111/j.1537-2995.2012.03934.x | pmc=3541531 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23294213  }}</ref>
{| class="wikitable"
* Headache
|+
* Numbness
! colspan="2" |Clinical history of TTP
* Weakness  
|-
* Dizziness  
|[[Thrombocytopenia]]
* Palpitation  
|[[Epistaxis]], [[bruising]], [[Petechia|petechiae]], [[Gingiva|gingival]] [[bleeding]], [[Hematuria|haematuria]], [[menorrhagia]], [[gastrointestinal bleeding]], [[retinal]] [[haemorrhage]] and [[Hemoptysis|haemoptysis]]
* Abdominal pain
|-
* Easy bruising  
|Central [[neurological]]
* Nausea and vomiting
|[[Confusion]], [[headache]], [[paresis]], [[aphasia]], [[dysarthria]], [[visual]] problems, [[encephalopathy]], [[stroke]]-like [[symptom]], [[coma]] (10%)
* Fever
|-
* Changes in the urine
|[[Kidney|Renal]] Impairment
'''<big>Less common</big>'''
|[[Proteinuria]], micro[[Hematuria|haematuria]]
* Chills
|-
* Chest pain
|Non-specific [[Symptom|symptoms]]
* Cough
|[[Pallor]], [[jaundice]], [[fatigue]], [[arthralgia]] or [[myalgia]]
|-
|[[Jaundice]]
|Resulting from [[Microangiopathic hemolytic anemia|microangiopathic haemolytic anaemia]]
|-
|[[Cardiac]]
|[[Chest pain]], [[heart]] [[failure]], [[hypotension]]
|-
|[[Gastrointestinal tract|Gastro-intestinal trac]]<nowiki/>t([[Gastrointestinal tract|GI]])
|[[Abdominal pain]], [[nausea]] and [[vomiting]]
|-
|[[Skin]]
|[[Skin]] [[bleeding]] – [[purpura]] and [[Petechia|petechiae]]
|}
 
===Common Symptoms===
*Common [[Symptom|symptoms]] of TTP include:<ref name="pmid23294213">{{cite journal| author=Griffin D, Al-Nouri ZL, Muthurajah D, Ross JR, Ballard RB, Terrell DR et al.| title=First symptoms in patients with thrombotic thrombocytopenic purpura: what are they and when do they occur? | journal=Transfusion | year= 2013 | volume= 53 | issue= 1 | pages= 235-7 | pmid=23294213 | doi=10.1111/j.1537-2995.2012.03934.x | pmc=3541531 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23294213  }}</ref><ref name="pmid11604563">{{cite journal |vauthors=Medina PJ, Sipols JM, George JN |title=Drug-associated thrombotic thrombocytopenic purpura-hemolytic uremic syndrome |journal=Curr. Opin. Hematol. |volume=8 |issue=5 |pages=286–93 |date=September 2001 |pmid=11604563 |doi= |url=}}</ref>
**History of [[Autoimmunity|autoimmune]] [[disease]] like [[SLE]]
** History of [[surgery]] or [[Organ transplant|transplant]]
** [[Drug]] history
** Initial [[Symptom|symptoms]]: [[Fatigue]], [[Pallor|pale]] and/or red [[skin]], shortness of [[breath]], [[Bruise|bruises]], [[bleeding]]
** [[Headache]]
** [[Numbness]]
** [[Weakness]]
** [[Dizziness]]
** [[Palpitation]]
** [[Abdominal pain]]
** Easy [[Bruise|bruising]]
** [[Nausea]] and [[Nausea and vomiting|vomiting]]
** [[Fever]]
** Changes in the [[urine]]
 
===Less Common Symptoms===
*Less common [[Symptom|symptoms]] of TTP include:
** [[Chills]]
** [[Chest pain]]
** [[Cough]]


==References==
==References==

Latest revision as of 16:17, 31 March 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]; Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [3]

Overview

The majority of patients with TTP are asymptomatic. However, the classic pentad of signs/symptoms includes microangiopathic hemolytic anemia, renal failure, thrombocytopenia, neurologic dysfunction, and fever.

History and Symptoms

History

Clinical history of TTP
Thrombocytopenia Epistaxis, bruising, petechiae, gingival bleeding, haematuria, menorrhagia, gastrointestinal bleeding, retinal haemorrhage and haemoptysis
Central neurological Confusion, headache, paresis, aphasia, dysarthria, visual problems, encephalopathy, stroke-like symptom, coma (10%)
Renal Impairment Proteinuria, microhaematuria
Non-specific symptoms Pallor, jaundice, fatigue, arthralgia or myalgia
Jaundice Resulting from microangiopathic haemolytic anaemia
Cardiac Chest pain, heart failure, hypotension
Gastro-intestinal tract(GI) Abdominal pain, nausea and vomiting
Skin Skin bleedingpurpura and petechiae

Common Symptoms

Less Common Symptoms

References

  1. Scully M, Hunt BJ, Benjamin S, Liesner R, Rose P, Peyvandi F, Cheung B, Machin SJ (August 2012). "Guidelines on the diagnosis and management of thrombotic thrombocytopenic purpura and other thrombotic microangiopathies". Br. J. Haematol. 158 (3): 323–35. doi:10.1111/j.1365-2141.2012.09167.x. PMID 22624596.
  2. Griffin D, Al-Nouri ZL, Muthurajah D, Ross JR, Ballard RB, Terrell DR; et al. (2013). "First symptoms in patients with thrombotic thrombocytopenic purpura: what are they and when do they occur?". Transfusion. 53 (1): 235–7. doi:10.1111/j.1537-2995.2012.03934.x. PMC 3541531. PMID 23294213.
  3. Medina PJ, Sipols JM, George JN (September 2001). "Drug-associated thrombotic thrombocytopenic purpura-hemolytic uremic syndrome". Curr. Opin. Hematol. 8 (5): 286–93. PMID 11604563.

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