THROMBOTIC THROMBOCYTOPENIC PURPURA: OUR CLINICAL EXPERIENCE

Objective: To assess clinical presentation and outcome of patients with thrombotic thrombocytopenic purpura (TTP) in our setup. Study Design: Descriptive study. Place and Duration of Study: Combined Military Hospital (CMH) Peshawar, from Feb 2016 to Aug 2017. Patients and Methods: In a prospecti...

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Autores principales: Zahid Farooq Baig, Aamir Farukh, Mumtaz Amir, Aslam Khan, Nadir Ali
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Lenguaje:EN
Publicado: Army Medical College Rawalpindi 2018
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Acceso en línea:https://doaj.org/article/6f6f726701fe46bbb981d490d7273bf8
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spelling oai:doaj.org-article:6f6f726701fe46bbb981d490d7273bf82021-12-01T02:52:00ZTHROMBOTIC THROMBOCYTOPENIC PURPURA: OUR CLINICAL EXPERIENCE0030-96482411-8842https://doaj.org/article/6f6f726701fe46bbb981d490d7273bf82018-10-01T00:00:00Zhttps://www.pafmj.org/index.php/PAFMJ/article/view/2224/1931https://doaj.org/toc/0030-9648https://doaj.org/toc/2411-8842Objective: To assess clinical presentation and outcome of patients with thrombotic thrombocytopenic purpura (TTP) in our setup. Study Design: Descriptive study. Place and Duration of Study: Combined Military Hospital (CMH) Peshawar, from Feb 2016 to Aug 2017. Patients and Methods: In a prospective design, patients diagnosed to be suffering from TTP, were included in this study. Detailed history along with physical examination and thorough investigation of all cases was carried out and collected on proformas. The diagnosis of TTP in our study was done by demonstration of significant schistocytes (more than 1 percent) on peripheral blood film. The patients were treated with steroids and plasma pheresis and in some cases with weekly Rituximab for 4 weeks. The patients were followed up in outdoor clinic on monthly basis. Results: Being a very rare disease, only 11 patients suffering from TTP reported during the study period. They were followed prospectively with a mean duration of follow-up of 11.23 months (± SD 5.57). All patients (100 percent) had anaemia, thrombocytopenia and acute kidney injury. Fever was seen in 54.4% patients and 63.6% patients had neurological involvement. A likely secondary cause of precipitation of TTP was found in 54.5% cases. The mortality rate was 18.2 percent. Conclusion: TTP is a challenging disease for intensive care specialists and can be fatal without effective treatment. A high index of suspicion followed by early diagnosis and prompt treatment can save life. Documentation of deficiency of plasma ADAMTS13 activity is not essential for the diagnosis of TTP and plasmapheresis is the treatment of choice.Zahid Farooq BaigAamir FarukhMumtaz AmirAslam KhanNadir AliArmy Medical College Rawalpindiarticlepakistan thrombotic microangiopathyplasmapheresisMedicineRMedicine (General)R5-920ENPakistan Armed Forces Medical Journal, Vol 68, Iss 5, Pp 1066-1070 (2018)
institution DOAJ
collection DOAJ
language EN
topic pakistan thrombotic microangiopathy
plasmapheresis
Medicine
R
Medicine (General)
R5-920
spellingShingle pakistan thrombotic microangiopathy
plasmapheresis
Medicine
R
Medicine (General)
R5-920
Zahid Farooq Baig
Aamir Farukh
Mumtaz Amir
Aslam Khan
Nadir Ali
THROMBOTIC THROMBOCYTOPENIC PURPURA: OUR CLINICAL EXPERIENCE
description Objective: To assess clinical presentation and outcome of patients with thrombotic thrombocytopenic purpura (TTP) in our setup. Study Design: Descriptive study. Place and Duration of Study: Combined Military Hospital (CMH) Peshawar, from Feb 2016 to Aug 2017. Patients and Methods: In a prospective design, patients diagnosed to be suffering from TTP, were included in this study. Detailed history along with physical examination and thorough investigation of all cases was carried out and collected on proformas. The diagnosis of TTP in our study was done by demonstration of significant schistocytes (more than 1 percent) on peripheral blood film. The patients were treated with steroids and plasma pheresis and in some cases with weekly Rituximab for 4 weeks. The patients were followed up in outdoor clinic on monthly basis. Results: Being a very rare disease, only 11 patients suffering from TTP reported during the study period. They were followed prospectively with a mean duration of follow-up of 11.23 months (± SD 5.57). All patients (100 percent) had anaemia, thrombocytopenia and acute kidney injury. Fever was seen in 54.4% patients and 63.6% patients had neurological involvement. A likely secondary cause of precipitation of TTP was found in 54.5% cases. The mortality rate was 18.2 percent. Conclusion: TTP is a challenging disease for intensive care specialists and can be fatal without effective treatment. A high index of suspicion followed by early diagnosis and prompt treatment can save life. Documentation of deficiency of plasma ADAMTS13 activity is not essential for the diagnosis of TTP and plasmapheresis is the treatment of choice.
format article
author Zahid Farooq Baig
Aamir Farukh
Mumtaz Amir
Aslam Khan
Nadir Ali
author_facet Zahid Farooq Baig
Aamir Farukh
Mumtaz Amir
Aslam Khan
Nadir Ali
author_sort Zahid Farooq Baig
title THROMBOTIC THROMBOCYTOPENIC PURPURA: OUR CLINICAL EXPERIENCE
title_short THROMBOTIC THROMBOCYTOPENIC PURPURA: OUR CLINICAL EXPERIENCE
title_full THROMBOTIC THROMBOCYTOPENIC PURPURA: OUR CLINICAL EXPERIENCE
title_fullStr THROMBOTIC THROMBOCYTOPENIC PURPURA: OUR CLINICAL EXPERIENCE
title_full_unstemmed THROMBOTIC THROMBOCYTOPENIC PURPURA: OUR CLINICAL EXPERIENCE
title_sort thrombotic thrombocytopenic purpura: our clinical experience
publisher Army Medical College Rawalpindi
publishDate 2018
url https://doaj.org/article/6f6f726701fe46bbb981d490d7273bf8
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AT mumtazamir thromboticthrombocytopenicpurpuraourclinicalexperience
AT aslamkhan thromboticthrombocytopenicpurpuraourclinicalexperience
AT nadirali thromboticthrombocytopenicpurpuraourclinicalexperience
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