TTP IS A MEDICAL EMERGENCY
It is due to a deficiency of the VWF cleaving protein, ADAMTS 13,
leading to spontaneous platelet aggregation in the microvasculature
Suspect if LOW PLATELETS + MAHA*
*MAHA = micro-angiopathic haemolytic anaemia = falling Hb
with fragmentation and micro-spherocytes on blood film
REFERRAL CRITERIA
CLINICAL FEATURES
Bruising, bleeding
Neurological symptoms e.g.
headache, confusion, seizures
Fever
History of TTP
LABORATORY TESTING
Platelets median 10-30
Hb median 8-10, fragmentation on film
Haemolysis screen +ve DCT -ve
retics, haptoglobins, LDH , bilirubin
eGFR
Clotting screen normal
IF YOUR PATIENT HAS ALL OR A COMBINATION OF THE ABOVE
CALL ROYAL LIVERPOOL UNIVERSITY HOSPITAL
HAEMATOLOGY CONSULTANT ON CALL