Heather Health- Nursing Ttp Definition

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Health- Nursing

TTP

Definition of TTP

Inherited

Acquired

Etiology of TTP

Signs and Symptom of TTP

Purpura

Petechiae

Preventative Measures

Low Dose Aspirin Therapy

Splenectomy

Plasma Exchange

Thrombotic thrombocytopenic purpura (TTP) is a blood condition that causes blood clots in small blood vessels all through a person's body. It is a very rare disease that doesn't occur very often. These blood clots can cause severe problems if they are formed. They end up preventing blood flow to the brain, kidneys, or heart. Blood clots are formed when blood cell fragments called platelets all clump together. Platelets which are made in a person's bone marrow stick together in order to close small cuts and stop bleeding. When blood clots are formed there are fewer platelets to be found in the blood. The result of this can be bleeding under the skin, extended bleeding from cuts, and internal bleeding. Thrombotic refers to the blood clots that are formed. Thrombocytopenic means that the blood has a lesser than normal number of platelets in it. Purpura refers to purple bruises that are caused by bleeding under the skin (What Is Thrombotic Thrombocytopenic Purpura, 2009).

There are two major types of TTP. One is inherited and the other is acquired. Inherited refers to the condition being given from parents to children genetically. This type of TTP mostly affects children and newborn babies. In regards to inherited TTP, the ADAMTS13 gene is thought to be faulty in that it doesn't prompt the body to make a normal enzyme. Because of this enzyme activity is lacking. Acquired TTP is the more common type of the disease. Acquired refers to not being born with the disease but developing it over time. This type of TTP usually occurs in adults, but sometimes is found in children (What Is Thrombotic Thrombocytopenic Purpura, 2009).

Often times this disease occurs after the use of estrogen or after pregnancy. Pregnancy-associated TTP accounts for 10-25% of all TTP patients. In this case it usually occurs before the 24th week of gestation. Sometimes TTP occurs after a person has had a viral or bacterial infection. It is also know to be associated with HIV. There are also many other causes which include cancer, collagen, and vascular disorders and sometimes drug sensitivities. Drugs that are suspect in causing TTP include: immunosuppressive agents, ticlopidine, penicillin, and rifampin. Toxins that sometimes cause TTP include E. coli, spider and bee venom. Cancer drugs that are linked to TTP include: tamoxifen, bleomycin, and mitomycin (Thrombotic Thrombocytopenic Purpura, 2006).

The signs and symptoms of TTP include bruises that are purplish in color on the skin or mucous membranes that are caused by bleeding under the skin. These bruises are known as purpura. Pinpoint-sized red or purple dots often appear on the skin and are found in groups that may look like a rash. These spots, called petechiae, are caused by bleeding under the skin. Patients often suffer from paleness or jaundice accompanied by fatigue and fever. They often have a quickened heart rate and shortness of breath. Symptoms often include a headache, speech changes, confusion, coma, stroke, or seizure. There is sometimes found to be a protein or blood in the urine (What Are the Signs and Symptoms of Thrombotic Thrombocytopenic Purpura, 2009).

Although most people will only have one episode of TTP in their lifetime, a small percentage of people have repeated episodes. Some research has shown that during a 10-year period from the initial onset of the disease about a third of patients will have at least one relapse. A relapse can occur up to eight years after the initial episode. Currently there is no way to identify those who might relapse. Doctors often recommend long-term preventative measures that include low dose aspirin. In one study a splenectomy was shown to reduce the risk of relapse. Since it is possible for TTP to recur it is important that all patients remain under the care of a hematologist. Medical attention should be obtained immediately if symptoms or signs of TTP recur since fast treatment is thought to shorten the duration of a relapse (Allford, 2009).