Thrombotic thrombocytopenic purpura differential diagnosis
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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.