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 PEX1
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 or organ damage
Blood must be taken prior to treatment to assess baseline ADAMTS13 activity.
Severely reduced ADAMTS13 activity helps to confirm the diagnosis of TTP1
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…
It can be very difficult to diagnose an acute TTP episode and in many patients there are no specific, definitive clinical signs.