Thrombotic thrombocytopenic purpura history and symptoms: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{ | {{Thrombotic thrombocytopenic purpura}} | ||
{{CMG}}; {{AE}} {{S.G.}} | {{CMG}} {{shyam}}; {{AE}} {{S.G.}} | ||
==Overview== | ==Overview== | ||
The majority of patients with | 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=== | ===History=== | ||
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> | *[[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> | ||
{| class="wikitable" | {| class="wikitable" | ||
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! colspan="2" |Clinical history of TTP | ! colspan="2" |Clinical history of TTP | ||
|- | |- | ||
|Thrombocytopenia | |[[Thrombocytopenia]] | ||
|Epistaxis, bruising, petechiae, gingival bleeding, haematuria, menorrhagia, gastrointestinal bleeding, retinal haemorrhage and haemoptysis | |[[Epistaxis]], [[bruising]], [[Petechia|petechiae]], [[Gingiva|gingival]] [[bleeding]], [[Hematuria|haematuria]], [[menorrhagia]], [[gastrointestinal bleeding]], [[retinal]] [[haemorrhage]] and [[Hemoptysis|haemoptysis]] | ||
|- | |||
|Central [[neurological]] | |||
|[[Confusion]], [[headache]], [[paresis]], [[aphasia]], [[dysarthria]], [[visual]] problems, [[encephalopathy]], [[stroke]]-like [[symptom]], [[coma]] (10%) | |||
|- | |- | ||
| | |[[Kidney|Renal]] Impairment | ||
| | |[[Proteinuria]], micro[[Hematuria|haematuria]] | ||
|- | |- | ||
| | |Non-specific [[Symptom|symptoms]] | ||
| | |[[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 Symptoms=== | ||
Common symptoms of | *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 autoimmune disease like SLE | **History of [[Autoimmunity|autoimmune]] [[disease]] like [[SLE]] | ||
* History of surgery or transplant | ** History of [[surgery]] or [[Organ transplant|transplant]] | ||
* Drug history | ** [[Drug]] history | ||
* Initial symptoms: Fatigue, pale and/or red skin, shortness of breath, bruises, bleeding | ** Initial [[Symptom|symptoms]]: [[Fatigue]], [[Pallor|pale]] and/or red [[skin]], shortness of [[breath]], [[Bruise|bruises]], [[bleeding]] | ||
* Headache | ** [[Headache]] | ||
* Numbness | ** [[Numbness]] | ||
* Weakness | ** [[Weakness]] | ||
* Dizziness | ** [[Dizziness]] | ||
* Palpitation | ** [[Palpitation]] | ||
* Abdominal pain | ** [[Abdominal pain]] | ||
* Easy bruising | ** Easy [[Bruise|bruising]] | ||
* Nausea and vomiting | ** [[Nausea]] and [[Nausea and vomiting|vomiting]] | ||
* Fever | ** [[Fever]] | ||
* Changes in the urine | ** Changes in the [[urine]] | ||
===Less Common Symptoms=== | ===Less Common Symptoms=== | ||
Less common symptoms of TTP include: | *Less common [[Symptom|symptoms]] of TTP include: | ||
*Chills | ** [[Chills]] | ||
* Chest pain | ** [[Chest pain]] | ||
* Cough | ** [[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 bleeding – purpura and petechiae |
Common Symptoms
Less Common Symptoms
- Less common symptoms of TTP include:
References
- ↑ 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.
- ↑ 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.
- ↑ 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.