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]]) | |||
* Malignant Hypertension | |||
* Hematological abnormalities | |||
* Ischemic manifestations linked to autoimmune diseases | |||
== Differential Diagnosis == | == Differential Diagnosis == | ||
The main differential diagnosis of TTP is [[hemolytic-uremic syndrome]] (HUS | 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 | ||
* TMA syndromes | * [[TMA]] [[Syndrome|syndromes]] | ||
* Disseminated | * Disseminated intravascular coagulation | ||
* Hypertension | * Hypertension | ||
* Immune Thrombocytopenic Purpura (ITP) | * Immune Thrombocytopenic Purpura (ITP) | ||
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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 desaeses such as TMA syndromes, disseminated intravascular coagulation ,hypertension, immune thrombocytopenic purpura (ITP)
- Malignant Hypertension
- Hematological abnormalities
- Ischemic manifestations linked to autoimmune diseases
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
- TMA syndromes
- Disseminated intravascular coagulation
- Hypertension
- Immune Thrombocytopenic Purpura (ITP)
- Malignant Hypertension
- Hematological abnormalities
- Ischemic manifestations linked to autoimmune diseases
Differentiating TTP from other diseases on the basis of [symptom 1], [symptom 2], and [symptom 3]
On the basis rombocytopenia, MAHA, fluctuating neurological signs, renal faluer and fever, TTP must be differentiated from[2]
- Autoimmune haemolysis
- Evans syndrome Disseminated intravascular coagulation Pregnancy-associated such as: HELLP (haemolysis, elevated liver enzymes and low platelets), eclampsia
- haemolytic uraemic syndrome
- Drugs: quinine, simvastatin, interferon, Calcineurin inhibitors
- Malignant hypertension
- Infections (typically viral (cytomegalovirus, adenovirus, herpes simplex virus)
- Severe bacterial (meningococcus, pneumococcus)
- Fungal Autoimmune disease (lupus nephritis, acute scleroderma)
- Vasculitis Haemolytic uraemic syndrome (diarrhoea positive/negative)
- Malignancy Catastrophic antiphospholipid syndrom
References
- ↑ 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.
- ↑ 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.