Two emergency thrombocytopenias: DIC and TTP. HIT too.
#Thrombotic Thrombocytopenic Purpura (TTP)
TTP is an emergency
TTP is defined by a pentad.
Mnemonic is FAT RN
Fever
Anemia. The type of anemia is MAHA (Microangiopathic hemolytic anemia)
Thrombocytopenia
Renal problems
Neurologic symptoms
You only need thrombocytopenia and anemia (MAHA) to make a diagnosis of TTP.
What causes TTP?
TTP is caused by a deficiency of ADAMTS13.
vWF is a large multimer that helps with clotting. It goes through the blood to do its job. ADAMTS13 helps to cleave vWF into smaller parts making it easy to go through the blood vessels. When it is lacking, the large multimers of vWF block small vessels.