17. TTP/HUS

Question 1

Diagnosis of TTP and HUS

Answer 1

1. Unexplained thrombocytopenia (<20,000/µL)+ MAHA –> sufficient to establish the diagnosis
2. hemolytic lab, negative coomb tests
3. PT, PTT, fibrinogen normal (DD with DIC which has elevated PT/PTT)
4. ADAMTS13 ↓, Creatinine↑ (HUS>TTP)

Question 2

what triad is seen in HUS?

Answer 2

Thrombocytopenia
MAHA
AKI

*usually presents with prodrome of bloody diarrhea (due to EHEC infection)

Question 3

what pentad is seen in TTP?

Answer 3

Thrombocytopenia 
MAHA 
AKI 
\+/- Fever 
\+/- AMS

Question 4

treatment for TTP

Answer 4

• Urgent plasma exchange
• corticosteroids
• FFP if there’s a delay of plasma exchange
• Rituximab (refractory cases)