UMEM Educational Pearls

Category: Critical Care

Title: TTP

Posted: 10/2/2012 by Mike Winters, MD (Updated: 4/22/2024)
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Thrombotic Thrombocytopenic Purpura (TTP)

  • TTP is a true hematologic emergency.  As a result of delays in diagnosis and initiation of treatment, mortality remains around 20%.
  • Often, patients present with nonspecific symptoms that include weakness, anorexia, nausea, vomiting, and diarrhea.
  • Recall that the textbook pentad is rarely present upon presentation.  In fact, renal failure and neurologic deficits are late findings.
  • Plasma exchange remains the treatment of choice for critically ill ED patients with TTP.
  • If plasma exchange is not immediately available, consider FFP (15-30 ml/kg) and methylprednisolone (10 mg/kg).


Kessler CS, et al. Thrombotic thrombocytopenic purpura: A hematological emergency. J Emerg Med 2012; 43:538-44.