Different clinical severity of first episodes and recurrences of thrombotic thrombocytopenic purpura
Open Access
- 19 October 2010
- journal article
- research article
- Published by Wiley in British Journal of Haematology
- Vol. 151 (5), 488-494
- https://doi.org/10.1111/j.1365-2141.2010.08385.x
Abstract
The clinical course of thrombotic thrombocytopenic purpura (TTP) is characterized by recurrent disease episodes in up to 50% of cases. The clinical presentation and severity of different TTP episodes have not been systematically compared. Laboratory and clinical information from 51 patients with recurrent disease, derived from 136 patients with TTP included in the Milan TTP registry (URL: http://www.ttpdatabase.org), were used to compare mortality, symptoms and disease‐related laboratory measurements in different disease episodes. The prevalence of severe neurological symptoms (coma, seizures, and focal neurological defects) was significantly lower in recurrences than in the first episode. Platelet counts and haemoglobin levels at presentation were higher in recurrences than in the first disease episode, and lactate dehydrogenase levels were lower. Also, mortality tended to be lower in the second and third disease episodes than in the first. Recurrences of TTP are generally milder than first episodes. These differences in severity should be taken into account in clinical research on TTP and in patient management.This publication has 15 references indexed in Scilit:
- Survival and relapse in patients with thrombotic thrombocytopenic purpuraBlood, 2010
- Regional UK TTP Registry: correlation with laboratory ADAMTS 13 analysis and clinical featuresBritish Journal of Haematology, 2008
- Relationship between ADAMTS13 activity in clinical remission and the risk of TTP relapseBritish Journal of Haematology, 2008
- ADAMTS13 and anti-ADAMTS13 antibodies as markers for recurrence of acquired thrombotic thrombocytopenic purpura during remissionHaematologica, 2008
- The course of ADAMTS‐13 activity and inhibitor titre in the treatment of thrombotic thrombocytopenic purpura with plasma exchange and vincristineBritish Journal of Haematology, 2005
- von Willebrand factor cleaving protease (ADAMTS‐13) and ADAMTS‐13 neutralizing autoantibodies in 100 patients with thrombotic thrombocytopenic purpuraBritish Journal of Haematology, 2004
- Acute renal failure – definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) GroupCritical Care, 2004
- Thrombotic MicroangiopathiesThe New England Journal of Medicine, 2002
- Comparison of Plasma Exchange with Plasma Infusion in the Treatment of Thrombotic Thrombocytopenic PurpuraThe New England Journal of Medicine, 1991
- THROMBOTIC THROMBOCYTOPENIC PURPURAMedicine, 1966