pentad of TTP

Q: The classic "pentad" of Thrombotic thrombocytopenic purpura (TTP) is now considered obsolete?

A) True

B) False

Answer: A

Classically TTP is known for its "pentad," i.e.,

• microangiopathic hemolytic anemia (MAHA) 
• thrombocytopenia
• fever
• acute kidney injury
• severe neurologic findings

This pentad is preset only in less than 5 percent of the patients. TTP is a progressive disease. Since diagnosis and management are now readily done and available, classic pentad is rarely seen and considered obsolete in this age and time. Management with plasma exchange has been considered a game-changer in this regard.

#hematology

References:

1. Page EE, Kremer Hovinga JA, Terrell DR, et al. Thrombotic thrombocytopenic purpura: diagnostic criteria, clinical features, and long-term outcomes from 1995 through 2015. Blood Adv 2017; 1:590.

2. Amorosi EL, Ultmann JE. Thrombotic thrombocytopenic purpura: Report of 16 cases and review of the literature. Medicine (Baltimore) 1966; 45:139.