Thrombotic Thrombocytopenic Purpura

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Thrombotic Thrombocytopenic Purpura
Thrombotic Thrombocytopenic Purpura
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Video: Thrombotic Thrombocytopenic Purpura (TTP) 2023, February
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Thrombotic Thrombocytopenic Purpura (TTP)

Thrombotic thrombocytopenic purpura (TTP) is also known as thrombotic microangiopathy or Moschcowitz syndrome. TTP can be congenital or occur throughout life. It is unclear how the blood platelet count decreases and the resulting symptoms of TTP occur.

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Causes & Diagnosis

in the development of TTP, a connection with infections, autoimmune diseases, malignant tumors or pregnancy / childbirth is suspected. The inner layer of the vessels is damaged, the blood flow is disturbed, and blood cells are damaged. After successful treatment, relapses can occur again and again.

The characteristics of a TTP include:

  • Bleeding
  • confusion
  • Seizures
  • Paralysis
  • fever
  • weakness

Diagnostic measures should begin immediately. A brief overview of the medical history (e.g. known illnesses, medication intake) is obtained, laboratory tests (including blood count, blood coagulation tests / coagulation status, LDH, liver / kidney values) are initiated and an EKG (electrocardiogram) is prepared. X-ray examinations, CT, MR or EEG can also be used.

Note TTP is a medical emergency and must be treated immediately.

therapy

Treatment of TTP occurs immediately after the diagnosis is made. A stay in an intensive care unit may be necessary. The most effective method of TTP treatment is plasma exchange (plasmapheresis). In this case, blood plasma is exchanged for the plasma from healthy donors. The procedure takes about two to three hours and has few side effects. The plasma must be changed several times. In some cases, drugs are also used. If there is an underlying disease (e.g. an infection), it will be treated accordingly. Drugs that may have triggered the TTP are stopped.

After the therapy, the blood platelet count is checked regularly in the laboratory for half a year. As soon as a relapse is suspected, a quick diagnosis is carried out. If the course is chronic or if relapses occur repeatedly, surgical removal of the spleen is recommended. This requires preparatory vaccinations (pneumococci, meningococci, Haemophilus influenzae B) in order to compensate for the loss of the “immune shield” of the spleen.

Note Before surgical interventions or punctures (such as lumbar puncture) and dental interventions, it is absolutely necessary to state diseases of blood clotting. This is essential in order to take measures to keep the bleeding / thrombosis tendency as low as possible during surgery or dental treatment. Consultation with the attending physician is also essential if you are also using medication.

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