Monday, November 2, 2009

TTP/HUS

Pathophysiology: TTP is caused by a defect in ADAMTS13, a metalloproteinase responsible for the cleavage of vWF. This results in a hyper-coagulable state.

Clinical Presentation – Classic Pentad:

  1. Thrombocytopenia
  2. Renal Failure
  3. MAHA
  4. Fever
  5. Change in MS

Etiology:

Primary TTP: Idiopathic, autoimmune Abs against ADAMTS13

Secondary TTP: Mechanism unknown. Triggered by cancer, pregnancy etc.

HUS:

Seen more commonly in children. Triad of symptoms (MAHA, renal failure, and thrombocytopenia). Triggered by E. coli 0157:H7 infection.

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