Thrombotic Thrombocytopenic Purpura: A Tale of Two Cases

Microangiopathic hemolytic anaemia, thrombocytopenia, renal failure, neurologic abnormalities, and fever form the pentad of thrombotic thrombocytopenic purpura (TTP). Early diagnosis is crucial because TTP responds well to plasmapheresis therapy but is associated with substantial mortality if left untreated. A substantial percentage of patients with TTP used to die from systemic microvascular thrombosis in the brain and the heart. However, since plasma exchange therapy became a mainstay in the treatment of TTP, mortality has reduced considerably. Diagnosing TTP can be difficult due to the vast range of symptoms and the absence of clearly defined diagnostic criteria. Hemolytic uremic syndrome and disseminated intravascular coagulation are a close differential of TTP. Here we report two patients with TTP who achieved remission when treated with steroids, plasmapheresis and were free of disease relapse till about two months during follow-up in the outpatient department.