title: Thrombotic microangiopathies (TTP, HUS, HELLP).
abstract: 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.
authors: Department of Emergency Medicine, Medstar Georgetown University Hospital, Washington Hospital Center, 3800 Reservoir Road, Northwest, Washington, DC 20007, USA. Electronic address: sbk25@georgetown.edu.
authors: Shane
authors: S
authors: Kappler
authors: Department of Emergency Medicine, University of Cincinnati, University Hospital, 231 Albert Sabin Way, PO Box 670769, Cincinnati, OH 45267, USA.
authors: Sarah
authors: S
authors: Ronan-Bentle
authors: Department of Emergency Medicine, Medstar Georgetown University Hospital, Washington Hospital Center, 3800 Reservoir Road, Northwest, Washington, DC 20007, USA. Electronic address: autumngraham@gmail.com.
authors: Autumn
authors: A
authors: Graham
mesh_terms: D000328:Adult; D002648:Child; D005260:Female; D017359:HELLP Syndrome / Q000175:diagnosis / Q000628:therapy; D006463:Hemolytic-Uremic Syndrome / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D011247:Pregnancy; D011697:Purpura, Thrombotic Thrombocytopenic / Q000175:diagnosis / Q000628:therapy; D013921:Thrombocytopenia / Q000209:etiology; D057049:Thrombotic Microangiopathies / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy
chemical_list: D007166:Immunosuppressive Agents
keywords: DIC; HELLP; HUS; Hemolytic anemia; ITP; Microangiopathies; TTP; Thrombocytopenia