UMEM Educational Pearls

Category: Critical Care

Title: TTP

Posted: 10/2/2012 by Mike Winters, MD (Updated: 9/29/2023)
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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.