Thrombocytopenic purpura (TTP)

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  1. Life threatening condition caused by immune mediated platelet aggregation (unknown cause) with widespread microvascular thrombosis (similar to DIC); usually seen in young women
  2. Symptoms: pentad of fever, neurologic changes (depressed consciousness, coma, seizures), acute renal failure, thrombocytopenia, and microangiopathic hemolytic anemia ( may also have abdominal pain)
    1. Remember: Brain FART – Brain (neurologic changes), Fever, Anemia, Renal failure, Thrombocytopenia
  3. Not associated with other coagulation abnormalities which distinguishes it from DIC; diagnosis is confirmed by schistocytes in the blood smear
  4. Treatment: plasma exchange (1.5 times plasma volume); DO NOT give platelets as it can aggrevate the underlying thrombosis
  5. Prognosis: 90% survival with plasma exchange
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