Thrombotic thrombocytopenic purpura history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]; Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [3]


The majority of patients with TTP are asymptomatic. However, the classic pentad of signs/symptoms includes microangiopathic hemolytic anemia, renal failure, thrombocytopenia, neurologic dysfunction, and fever.

History and Symptoms


Clinical history of TTP
Thrombocytopenia Epistaxis, bruising, petechiae, gingival bleeding, haematuria, menorrhagia, gastrointestinal bleeding, retinal haemorrhage and haemoptysis
Central neurological Confusion, headache, paresis, aphasia, dysarthria, visual problems, encephalopathy, stroke-like symptom, coma (10%)
Renal Impairment Proteinuria, microhaematuria
Non-specific symptoms Pallor, jaundice, fatigue, arthralgia or myalgia
Jaundice Resulting from microangiopathic haemolytic anaemia
Cardiac Chest pain, heart failure, hypotension
Gastro-intestinal tract(GI) Abdominal pain, nausea and vomiting
Skin Skin bleedingpurpura and petechiae

Common Symptoms

Less Common Symptoms


  1. Scully M, Hunt BJ, Benjamin S, Liesner R, Rose P, Peyvandi F, Cheung B, Machin SJ (August 2012). "Guidelines on the diagnosis and management of thrombotic thrombocytopenic purpura and other thrombotic microangiopathies". Br. J. Haematol. 158 (3): 323–35. doi:10.1111/j.1365-2141.2012.09167.x. PMID 22624596.
  2. Griffin D, Al-Nouri ZL, Muthurajah D, Ross JR, Ballard RB, Terrell DR; et al. (2013). "First symptoms in patients with thrombotic thrombocytopenic purpura: what are they and when do they occur?". Transfusion. 53 (1): 235–7. doi:10.1111/j.1537-2995.2012.03934.x. PMC 3541531. PMID 23294213.
  3. Medina PJ, Sipols JM, George JN (September 2001). "Drug-associated thrombotic thrombocytopenic purpura-hemolytic uremic syndrome". Curr. Opin. Hematol. 8 (5): 286–93. PMID 11604563.

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