Thrombotic thrombocytopenic purpura differential diagnosis: Difference between revisions

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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 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 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>
* Autoimmune haemolysis
**Autoimmune haemolysis
* Evans syndrome Disseminated intravascular coagulation Pregnancy-associated such as: HELLP (haemolysis, elevated liver enzymes and low platelets), eclampsia
**Evans syndrome Disseminated intravascular coagulation Pregnancy-associated such as: HELLP (haemolysis, elevated liver enzymes and low platelets), eclampsia
* haemolytic uraemic syndrome  
**haemolytic uraemic syndrome  
* Drugs: quinine, simvastatin, interferon, Calcineurin inhibitors
**Drugs: quinine, simvastatin, interferon, Calcineurin inhibitors
* Malignant hypertension  
**Malignant hypertension  
* Infections (typically viral (cytomegalovirus, adenovirus, herpes simplex virus)  
**Infections (typically viral (cytomegalovirus, adenovirus, herpes simplex virus)  
* Severe bacterial (meningococcus, pneumococcus)
**Severe bacterial (meningococcus, pneumococcus)
* Fungal Autoimmune disease (lupus nephritis, acute scleroderma)  
**Fungal Autoimmune disease (lupus nephritis, acute scleroderma)  
* Vasculitis Haemolytic uraemic syndrome (diarrhoea positive/negative)  
**Vasculitis Haemolytic uraemic syndrome (diarrhoea positive/negative)  
* Malignancy Catastrophic antiphospholipid syndrom
**Malignancy Catastrophic antiphospholipid syndro
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Revision as of 13:23, 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 desaeses 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:

  • 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 syndro

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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