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Thrombotic Microangiopathies (TTP, HUS, HELLP)

Shane Kappler1, Sarah Ronan-Bentle2, Autumn Graham1

  • 1Department of Emergency Medicine, Medstar Georgetown University Hospital, Washington Hospital Center, 3800 Reservoir Road, Northwest, Washington, DC 20007, USA.

Hematology/Oncology Clinics of North America
|October 29, 2017
PubMed

Thrombocytopenia, strictly defined as a platelet count less than 150,000, is common in the emergency department. Recognition, diagnostic investigation, and proper disposition of a thrombocytopenic patient are imperative. One group of disorders leading to thrombocytopenia is the thrombotic microangiopathies, hallmarked by platelet destruction. These thrombotic microangiopathies include thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS) and hemolysis, elevated liver enzyme levels, low platelet count (HELLP), which should be distinguished from similar disease processes such as immune thrombocytopenia (ITP), disseminated intravascular coagulation (DIC) and heparin induced thrombocytopenia (HIT). In this article, clinical presentations, pathophysiology, diagnostic workup, management plans, complications, and dispositions are addressed for this complex group of platelet disorders.

Keywords:
DICHELLPHUSHemolytic anemiaITPMicroangiopathiesTTPThrombocytopenia

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