How is thrombotic thrombocytopenic purpura (TTP) differentiated from hemolytic-uremic syndrome (HUS)?

Updated: Feb 18, 2019
  • Author: Theodore Wun, MD, FACP; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Answer

Clinical differentiation of hemolytic-uremic syndrome (HUS) and TTP can be problematic. Differentiation is often based on the presence of CNS involvement in TTP and the more severe renal involvement in HUS. In HUS, an antecedent history of diarrheal illness is more often present. In fact, some investigators suggest a clinical classification of HUS based on the presence or absence of diarrhea.

In children, the distinction between HUS and TTP may be of more importance, as general supportive measures (with dialysis as needed) are the standard therapy for HUS, versus plasma exchange for TTP. However, albeit somewhat controversial, plasma exchange is performed in adults with HUS so the differentiation has less therapeutic implications at present.


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