Thrombotic thrombocytopenic purpura differential diagnosis: Difference between revisions

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{{CMG}} {{AE}} {{S.G.}}
{{CMG}} {{AE}} {{S.G.}}
==Overview==
==Overview==
The main differential diagnosis of TTP is [[hemolytic-uremic syndrome]]. TTP should be diffrential from the other desaeses such as [[TMA]] [[Syndrome|syndromes]], disseminated [[intravascular]] [[coagulation]] [[Hypertension|,hypertension]], [[Idiopathic thrombocytopenic purpura|immune thrombocytopenic purpura]] ([[Idiopathic thrombocytopenic purpura|ITP]])
The main differential [[diagnosis]] of TTP is [[hemolytic-uremic syndrome]]. TTP should be diffrential from the other [[Disease|disaeses]] such as [[TMA]] [[Syndrome|syndromes]], disseminated [[intravascular]] [[coagulation]] [[Hypertension|,hypertension]], [[Idiopathic thrombocytopenic purpura|immune thrombocytopenic purpura]] ([[Idiopathic thrombocytopenic purpura|ITP]])
* [[Malignant hypertension]]
* [[Malignant hypertension]]
* [[Hematological]] [[abnormalities]]
* [[Hematological]] [[abnormalities]]
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== Differential Diagnosis ==
== Differential Diagnosis ==
The main differential diagnosis of TTP is [[hemolytic-uremic syndrome]] ([[Hemolytic-uremic syndrome|HUS]], which has neurosymptoms, [[renal failure]], [[hypertension]] and [[fever]]).  Note that [[ADAMTS13]] [[Activity (chemistry)|activity]] is [[normal]] in [[Hemolytic-uremic syndrome|HUS]].<ref name="JolyCoppo2017">{{cite journal|last1=Joly|first1=Bérangère S.|last2=Coppo|first2=Paul|last3=Veyradier|first3=Agnès|title=Thrombotic thrombocytopenic purpura|journal=Blood|volume=129|issue=21|year=2017|pages=2836–2846|issn=0006-4971|doi=10.1182/blood-2016-10-709857}}</ref>
The main differential [[diagnosis]] of TTP is [[hemolytic-uremic syndrome]] ([[Hemolytic-uremic syndrome|HUS]], which has neurosymptoms, [[renal failure]], [[hypertension]] and [[fever]]).  Note that [[ADAMTS13]] [[Activity (chemistry)|activity]] is [[normal]] in [[Hemolytic-uremic syndrome|HUS]].<ref name="JolyCoppo2017">{{cite journal|last1=Joly|first1=Bérangère S.|last2=Coppo|first2=Paul|last3=Veyradier|first3=Agnès|title=Thrombotic thrombocytopenic purpura|journal=Blood|volume=129|issue=21|year=2017|pages=2836–2846|issn=0006-4971|doi=10.1182/blood-2016-10-709857}}</ref>


TTP must be differentiated from
TTP must be differentiated from
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===Differentiating TTP from other diseases on the basis of Symptoms:===
===Differentiating TTP from other diseases on the basis of Symptoms:===


*On the basis rombocytopenia, MAHA, fluctuating [[neurological]] [[Medical sign|signs]], [[renal]] faluer and [[fever]], TTP must be differentiated from<ref name="KarpmanLoos2017">{{cite journal|last1=Karpman|first1=Diana|last2=Loos|first2=Sebastian|last3=Tati|first3=Ramesh|last4=Arvidsson|first4=Ida|title=Haemolytic uraemic syndrome|journal=Journal of Internal Medicine|volume=281|issue=2|year=2017|pages=123–148|issn=09546820|doi=10.1111/joim.12546}}</ref>
*On the basis [[thrombocytopenia]], MAHA, fluctuating [[neurological]] [[Medical sign|signs]], [[renal]] faluer and [[fever]], TTP must be differentiated from<ref name="KarpmanLoos2017">{{cite journal|last1=Karpman|first1=Diana|last2=Loos|first2=Sebastian|last3=Tati|first3=Ramesh|last4=Arvidsson|first4=Ida|title=Haemolytic uraemic syndrome|journal=Journal of Internal Medicine|volume=281|issue=2|year=2017|pages=123–148|issn=09546820|doi=10.1111/joim.12546}}</ref>
**[[Autoimmune]] [[Hemolysis|haemolysis]]
**[[Autoimmune]] [[Hemolysis|haemolysis]]
**[[Evans syndrome]] disseminated [[intravascular]] [[coagulation]] [[pregnancy]]-associated such as: [[HELLP syndrome|HELLP]] ([[Hemolysis|haemolysis]], elevated [[liver]] [[enzymes]] and low [[platelets]]), [[eclampsia]]
**[[Evans syndrome]] disseminated [[intravascular]] [[coagulation]] [[pregnancy]]-associated such as:
**haemolytic uraemic syndrome  
***[[HELLP syndrome|HELLP]] ([[Hemolysis|haemolysis]]
**Drugs: quinine, simvastatin, interferon, Calcineurin inhibitors
***Elevated [[liver]] [[enzymes]] and low [[platelets]])
**Malignant hypertension  
***[[eclampsia]]
**Infections (typically viral (cytomegalovirus, adenovirus, herpes simplex virus)  
**[[Hemolytic-uremic syndrome|Haemolytic uraemic syndrome]]
**Severe bacterial (meningococcus, pneumococcus)
**[[Drugs]]:
**Fungal Autoimmune disease (lupus nephritis, acute scleroderma)  
***[[Quinine]]
**Vasculitis Haemolytic uraemic syndrome (diarrhoea positive/negative)  
***[[simvastatin]]
**Malignancy Catastrophic antiphospholipid syndro
***[[interferon]]
***[[Calcineurin]] [[Inhibitor|inhibitors]]
**[[Malignant]] [[hypertension]]
**[[Infection|Infections]] (typically [[viral]] ([[cytomegalovirus]], [[adenovirus]], [[herpes simplex]] [[Virus (biology)|virus]])  
**Severe [[bacterial]] ([[meningococcus]], [[pneumococcus]])
**[[Fungal]] [[autoimmune]] [[disease]] ([[lupus nephritis]], [[Acute (medicine)|acute]] [[scleroderma]])  
**[[Vasculitis]] [[Hemolytic-uremic syndrome|haemolytic uraemic syndrome]] ([[Diarrhea|diarrhoea]] positive/negative)  
**[[Malignancy]] [[catastrophic antiphospholipid syndrome]]
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Latest revision as of 15:09, 6 March 2019


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

Overview

The main differential diagnosis of TTP is hemolytic-uremic syndrome. TTP should be diffrential from the other disaeses such as TMA syndromes, disseminated intravascular coagulation ,hypertension, immune thrombocytopenic purpura (ITP)

Differential Diagnosis

The main differential diagnosis of TTP is hemolytic-uremic syndrome (HUS, which has neurosymptoms, renal failure, hypertension and fever). Note that ADAMTS13 activity is normal in HUS.[1]

TTP must be differentiated from

Differentiating TTP from other diseases on the basis of Symptoms:

References

  1. Joly, Bérangère S.; Coppo, Paul; Veyradier, Agnès (2017). "Thrombotic thrombocytopenic purpura". Blood. 129 (21): 2836–2846. doi:10.1182/blood-2016-10-709857. ISSN 0006-4971.
  2. Karpman, Diana; Loos, Sebastian; Tati, Ramesh; Arvidsson, Ida (2017). "Haemolytic uraemic syndrome". Journal of Internal Medicine. 281 (2): 123–148. doi:10.1111/joim.12546. ISSN 0954-6820.

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