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Sunday, August 21, 2016

HUS & TTP

Resultado de imagen de American college of physicians
From the August 2016 ACP Hospitalist -  By Diab M and Imran N
"Thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS) represent 2 of many diverse thrombotic microangiopathy (TMA) syndromes that have in common clinical and pathological features (Table 1). Systemic conditions, including infections, malignancy, vitamin deficiency, and autoimmune disorders, can manifest similarly to primary TMAs, making diagnosis challenging. Furthermore, primary TMAs may sometimes remain indolent until precipitated by secondary conditions. The triad of microangiopathic hemolytic anemia (MAHA), thrombocytopenia, and end-organ damage dominates all TMA syndromes...
Conclusion
Early recognition of TTP and ST-HUS by hospitalists is crucial as poor outcomes result from delayed diagnosis and treatment. While plasma exchange is the standard of therapy for TTP, treatment of ST-HUS remains supportive. Plasma exchange has markedly improved the outcomes of TTP patients but not their survival. Furthermore, plasma exchange is not without risks. Future studies are needed to better identify approaches to improve outcomes in this patient population."