Thrombotic thrombocytopenic purpura

We had a great discussion of MAHA and TTP.

1.       Causes of macroangiopathic hemolytic anemia (MAHA) include; TTP, HUS, DIC, malignant HTN, vasculitis, eclampsia, HELLP, APLA syndrome, scleroderma renal crisis, metastatic cancer, calcineurin inhibitors, solid organ transplant rejection.

2.       The pentad of TTP and the percentage that each sign is present; MAHA (100%), Thrombocytopenia (100%), Neuro Changes (22%), Fevers (22%), reduced renal function (18%). 

3.        TTP is fatal 90% of the time if therapy is not given.  Treatment includes plasma exchange.