Clinical haematology · UKMLA & AKT

Thrombotic thrombocytopenic purpura (TTP)

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise thrombotic thrombocytopenic purpura (ttp) — the full SA Note notes add investigations, management, complications and 10 practice questions.

Key high-yield points

  • TTP is a thrombotic microangiopathy caused by absent/severely deficient ADAMTS13, leading to accumulation of ultra-large vWF multimers, platelet-rich microthrombi, and mechanical red cell fragmentation (microangiopathic haemolytic anaemia, MAHA).
  • Acquired TTP - IgG autoantibodies against ADAMTS13 (most common); triggers include pregnancy, HIV, SLE, drugs
  • Congenital TTP (Upshaw-Schulman syndrome) - ADAMTS13 gene mutations; presents in childhood
  • Drugs - quinine (most classic), ciclosporin, ticlopidine, mitomycin C, tacrolimus
  • Overrepresentation of Black African and Afro-Caribbean individuals in TTP registries

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Related UKMLA topics

Immune thrombocytopenia (ITP)Heparin-induced thrombocytopenia (HIT)Reactive thrombocytosisIdiopathic thrombocytopenic purpura (ITP)Patient on anti-platelet therapyyeloproliferative disorders