Overview: Thrombotic thrombocytopenic purpura, or TTP, is a rare blood disorder that causes a large amount of tiny blood clots, referred to as thromboses, to form in blood vessels around the body. If left untreated, TTP can lead to complications such as kidney failure, hemorrhaging, stroke, nervous system problems and death.
TTP is triggered by problems with the ADAMTS 13 enzyme, a specialized protein that is crucial to the blood clotting process. If the enzyme is not working properly or there is not enough of it, then excessive clotting occurs. In some cases, the enzyme deficiency that causes TTP is inherited; these patients are born with naturally low level of ADAMTS 13. Other patients might acquire the disorder through disease, medical procedures and certain drugs.
According to the National Heart Lung and Blood Institute conditions such as pregnancy, cancer, HIV, lupus and infections may all be significant risk factors for developing TTP. Surgery, chemotherapy and blood and marrow stem cells transplants may also increase this risk.
Medications such as ticlopidine, cyclosporine A, hormone therapy and estrogens and clopidogrel have been linked to TTP. Cyclosporine A is an immunosuppressant while ticlopidine and clopidogrel are both blood thinners used to reduce the risk of stroke in high risk patients. Clopidogrel is sold under the brand name Plavix, and recently went generic. According to MedicineNet.com, Plavix has largely replaced ticlopidine because no blood problems were detected in pre-marketing studies. After the drug was launched, however, several cases of TTP were linked to the blood thinner. In addition to TTP, Plavix (and its generic versions) has been associated with a higher risk of cerebral bleeding, severe ulcers, and hemorrhagic stroke.
In patients with TTP, the platelets are used up in the clotting process. This means that there are very few platelets left elsewhere in the body, which can cause bleeding under the skin. This may lead to purple spots known as purpura and tiny red or purple dots called petechiae; petechiae typically appear in large groups and resemble a rash.
Other symptoms include jaundice, fatigue, fever, fast heart rate or shortness of breath, headache, changes in speech, confusion and changes in consciousness.
Speak to your doctor if you think you have significant signs of thrombotic thrombocytopenic purpura. You will most likely require a hematologist, a physician who specializes in blood disorders. He or she will inquire about your symptoms and medical history. If you’ve taken medications such as the bloodthinner Plavix, be sure to disclose inform the doctor.