Clinical and laboratory profile of patients with thrombotic thrombocytopenic purpura seen at the University of Sto.Tomas Hospital: A single center experience

ABSTRACT

BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is considered a rare disease. In the Philippines, there are currently no local registry for such rare disease thus clinical features that may be unique to the country is difficult to characterize.OBJECTIVE: To characterize the TTP patients seen in our institution based on the demographic, clinical and laboratory profile of these patients.RESULTS: A total of eight patients were described in this report. Median age was 38 years (range, 20-63) with a female predominance. All patients had neurologic  symptoms and microangiopathic hemolytic anemia. Minor neurologic symptoms (confusion, headache and dizziness) were more frequently observed. Renal dysfunction (serum creatinine >1.4mg/dL), fever (>38.0°C), and thrombocytopenia were observed in four patients (50%), seven patients (87.5%) and six patients (75%) respectively. Patients underwent median of three sessions of Plasma Exchange (range, two to 38). Of the six patients who received therapeutic plasma exchange, five were discharged alive.CONCLUSION: Fifty percent of the patients in this report presented with the classic pentad. This feature should be kept in mind as TTP is a true hematopologic emergency. A high index of suspicion, prompt evaluation and treatment of patients are necessary because multi-organ thrombosis may not be reversible. If treatment is not urgently administered, Therapeutic Plasma Exchange is the management of choice and should be done immediately once TTP is recognized.