What is Thrombotic Thrombocytopenic Purpura?

Thrombotic thrombocytopenic purpura (TTP) is a blood disorder which causes blood clots to form in the small blood vessels of the body, and results in a low platelet count.

Causes of TTP

Causes of TTP are attributed to the lack of an enzyme which causes abnormal blood clotting. A person with thrombotic thrombyctopenic purpura suffers from platelets bunching together into clots, and has too few platelets accessible in the blood flow to other parts of the body. This abnormality of the platelets may lead to bleeding beneath the skin which is purple in appearance; these spots are called purpura.

In a lot of cases, TTP is passed down in families.

This condition can also be attributed to:

Cancer

Bone marrow transplantation

Chemotherapy

HIV/AIDS infection

Estrogen hormone replacement therapy

Symptoms of TTP

Symptoms of TTP (thrombotic thrombocytopenic purpura) include:

Bleeding in the skin and mucus membranes

Confusion

Fatigue

Fever

Tachycardia (heart rate above 100 beats per minute)

Headache

Pale skin

Purple colored blood spots near the skin's surface

Yellow color to the skin

Weakness

Changes in speech patterns

Shortness of breath (especially with exertion)

Diagnosing TTP

Diagnosing TTP is done after a series of tests are done. The tests include:

Blood smear - A drop of blood is collected and smeared onto a collection plate. The blood smear is examined under a microscope so that the cells can be examined by a medical professional.

CBC - This is a blood test that counts all the different types of cells in the blood sample.

Creatinine level - This is a blood test that measures kidney function.

LDH (Lactate dehydrogenase) level - This is a test that shows if there is tissue damage in the body. For instance, when a part of the body, such as the heart, kidney, liver or muscle suffers cellular damage, these tissues release the LDH enzyme.

Mucus membrane biopsy - This test is done by surgically removing a small piece of mucous membrane for microscopic evaluation.

Platelet count - A platelet count is usually done as part of a CBC. A platelet count is usually ordered when a patient has unexplained bruising on his/her body.

Urinalysis - A sample of urine is analyzed. The urine may be cultured to examine bacterial growth. The urine may also be examined for blood, urea, nitrogen, and proteins.

Treatment for TTP (thrombotic thrombocytopenic purpura)

Treatment for TTP is done via plasmapheresis, also known as plasma exchange. Plasma is removed and filtered to remove abnormal antibodies from the blood and to restore the missing enzyme. Your blood is drawn off like you are giving blood. The plasma portion of the blood is filtered through a cell separator. The antibodies are filtered out, and additional plasma is added to the remaining plasma is given back to you via transfusion. This treatment may be done daily, depending on the blood tests. The blood tests can be stopped when there is significant improvement in the blood stream.

Sometimes people don't respond very well to the treatment, or they have frequent recurrences of high platelet counts. These people may require surgery (splenectomy) to remove the spleen, or certain drugs such as corticosteroids may be given to suppress the immune system. Usually a plasma exchange or a series of exchanges is enough to help most patients recover.

Most people can be successfully treated for TTP, so that the condition can be managed. For those that don't respond well to treatment, a long term condition will result and could possibly lead to the death of the patient.

Conclusion

Though most people with TTP can be managed, there are some complications to the disorder which are possible. Due to the clumping of platelets in the small vessels, this can lead to strokes, heart attacks, and kidney failure. TTP can cause low levels of platelets in circulation; this condition is known as thrombocytopenia. This condition can lead to severe bleeding and hemorrhaging, and problems with the nervous system.

Sources:

Medline Plus

Web MD