Understanding a patient’s diagnosis

In this section you can find an infographic providing an overview of the diagnostic pathway in aTTP, and expert interviews discussing the challenges in diagnosing TTP.

TTP Diagnostic pathway

The diagnosis of TTP should be treated as a medical emergency.1

Thrombocytopaenia & MAHA in the absence of any
other identifiable cause => suspect TTP.1

Presenting clinical features and signs include1:

Thrombocytopenia

Jaundice

Central neurological symptoms

Renal impairment

Non-specific symptoms: pallor, jaundice, fatigue, arthralgia or myalgia

Gastrointestinal tract symptoms

Cardiac symptoms

Potential triggers of interest in clinical history2:

Bacterial or viral infections

Drug ingestion (quinine, ticlopidine, clopidogrel, mitomycin C, alpha-interferon, cyclosporin, tacrolimus and other immunosupressive and chemotherapeutic agents)

Pregnancy

Autoimmune disorders [mainly systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APL)]

Bone marrow transplantation

Disseminated malignancy

Tests and expected results may include1:

Blood samples should be sent for investigation before first PEX

Full blood count and blood film
Anaemia, thrombocytopenia, fragments on film.

Direct antiglobulin test
Negative

Reticulocyte count raised

Clotting screen including
fibrinogen normal

Haptoglobin reduced

Urea and electrolytes
Renal impairment

Lactate dehydrogenase raised due to haemolysis

Blood must be taken prior to treatment to assess baseline ADAMTS13 activity.

Severely reduced ADAMTS13 activity helps to confirm the diagnosis of TTP1

Dr. Marie Scully - signs, symptoms and diagnosis TTP

Dr. Marie Scully

The signs & symptoms of TTP

“TTP is an acute life threatening disorder that affects primarily young people and primarily females but it can occur at any age…”

“That was one week or 5 days that this girl was going around with the signs and symptoms but everybody thought that it is flu…”

Patient Case Study - Dr. Flora Peyvandi

Dr. Flora Peyvandi

Patient case study

Dr. Marie Scully - signs, symptoms and diagnosis TTP

Dr. Marie Scully

Diagnosing TTP

“It can be very difficult to diagnose an acute TTP episode and in many patients there are no specific, definitive clinical signs.”