title: Thrombotic thrombocytopenic purpura: a hematological emergency.
abstract: BACKGROUND
  Thrombotic thrombocytopenic purpura is a hematological emergency and diagnostic challenge. The critical determinant of outcome is timely diagnosis and treatment.
  
  
  OBJECTIVE
  Describe the pathophysiology, presentation, diagnosis, and treatment of thrombotic thrombocytopenic purpura.
  
  
  CONCLUSIONS
  Thrombotic thrombocytopenic purpura has a varied presentation and a tendency to mimic several disorders. However, it may be at least provisionally diagnosed in the patient with thrombocytopenia and microangiopathic hemolytic anemia without alternate cause. The mainstay of treatment is immediate plasma exchange to be repeated until platelet count is stabilized. Adjuvant therapies include corticosteroids, rituximab, and cyclosporine.
  
  
  CONCLUSIONS
  It is essential for the emergency physician to be aware of thrombotic thrombocytopenic purpura's range of presentations, diagnostic criteria, and treatment.
authors.affiliation: Department of Emergency Medicine, Jesse Brown VA Hospital, Chicago, IL 60612, USA.
authors.forename: Chad S
authors.initials: CS
authors.lastname: Kessler
authors.forename: Bilal A
authors.initials: BA
authors.lastname: Khan
authors.forename: Katie
authors.initials: K
authors.lastname: Lai-Miller
mesh_terms: D051722:ADAM Proteins / Q000172:deficiency / Q000276:immunology; D000071120:ADAMTS13 Protein; D058846:Antibodies, Monoclonal, Murine-Derived; D001327:Autoimmune Diseases / Q000150:complications; D016572:Cyclosporine; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006463:Hemolytic-Uremic Syndrome / Q000150:complications; D006801:Humans; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D007239:Infections / Q000150:complications; D009369:Neoplasms / Q000150:complications; D010951:Plasma Exchange; D017713:Platelet Transfusion; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic; D011379:Prognosis; D011697:Purpura, Thrombotic Thrombocytopenic / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D006435:Renal Dialysis; D000069283:Rituximab
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D005938:Glucocorticoids; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069283:Rituximab; D016572:Cyclosporine; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human