Which conditions are included in the differential diagnoses of thrombotic thrombocytopenic purpura (TTP)?

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

To make an accurate diagnosis, the clinician must recognize the similarity between thrombotic thrombocytopenic purpura (TTP) and hemolytic-uremic syndrome (HUS). In addition to HUS, the differential diagnosis also includes immune thrombocytopenic purpura (ITP) and disseminated intravascular coagulation (DIC), two entities with very different modes of therapy (see the image below).

Differential diagnosis of immune thrombocytopenic Differential diagnosis of immune thrombocytopenic purpura (ITP), thrombotic thrombocytopenic purpura (TTP), and disseminated intravascular coagulation (DIC).

Additional diagnoses that should be considered in patients presenting with an acute thrombotic microangiopathy (TMA), especially in those in whom levels of ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) activity are nondeficient (>10%) include the following [12] :

  • Drug-induced TMA
  • Cancer-associated TMA
  • Hematopoietic transplant–associated TMA

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