TTP (Thrombotic Thrombocytopenic Purpura)

What Is TTP?

 

TTP is a problem with the blood system in which platelets and red blood cells are destroyed at a very fast rate.  Red blood cells are needed to carry oxygen throughout your body.  Platelet cells are needed to stop bleeding.  For some unknown reason, your immune system begins to destroy your own platelets and red blood cells.  This causes symptoms of anemia (low red blood cell count) and bleeding.  You may notice weakness, fatigue, dizziness, headache and shortness of breath.  You may also have bleeding from your nose and mouth.  If you get a small cut it may not stop bleeding.  You might also notice a lot of bruises and small red spots on your arms, legs and other body sites.  Some people have confusion.

 

Symptoms of TTP

• Anemia - pale skin
• Weakness
• Chronic fatigue
• Confusion - not thinking right or clearly, memory loss
• Low grade fever
• Bleeding without clotting
• Bruising easily

 

 

 

 

Treatment: Plasmapheresis

 

Because having TTP can be an emergency, treatment with plasma pheresis is begun as soon as possible.  A large catheter will be placed in a vein in your neck or upper leg.  During pheresis we take out your blood, filter the plasma, add donor plasma and then return your blood cells to you.  This will be done daily until your platelets return to normal levels.  You might also receive transfusions of red blood cells or plasma.  Many lab values will be checked on a daily basis to find out how your blood is doing.

 

 

 

 

 

 

 

Glossary

 

Petechiae: A pin-point purplish-red spot on the skin and/or lining of mouth.  This is a sign that your platelets are low.  These are not painful.

 

Purpura:  Painless, dime-sized bruising that also shows a low platelet count.

 

Gambro: A catheter or tube used during plasmapheresis.  Blood is taken out of the body, filtered or cleaned, and then returned to the body through this tube.  It will be placed either in your upper leg or shoulder area.  When the tube is put in, your doctor will numb the area with a medicine like your dentist might use.  Once it is in, you may have minor soreness.

 

Platelets:  Cells in the blood that are needed for blood clotting.

 

Plasma: The liquid portion of your blood.  Plasma contains many proteins, the most important of which are clotting factors and immunoglobulins.

 

Immunoglobulins: A type of protein, which in found in plasma. They play a role in your body's destruction of your red blood cells and platelets. 

 

Plasmapheresis: Treatment used to remove plasma and immunoglobulins to stop the cycle of TTP.  The plasma, from blood donors, given back during the treatment contains clotting factors.  These clotting factors help prevent bleeding.  The treatment may last 2-3 hours.  You will be sitting in a lounge chair or in a bed during the treatment.  You should not expect any pain.

 

RBCs: Red blood cells (RBC's) are the cells in your blood that carry oxygen to your body tissues and organs.

 

Anemia: A state in which your body has a lower than normal amount of red blood cells.  When this happens you may have fatigue, weakness, and your skin may be pale.

Going Home

 

Your doctors will decide when it is time for you to stop having pheresis.  When your platelet count stays the same or rises to a normal level, you will be ready to go home.  Ask your doctor when it is okay to return to work and your normal activities.

 

After you go home, you will need to be watched closely in the clinic.  On a weekly basis, for about a month or as your doctor advises, you will have your blood/lab values checked.  This may be done at your local doctor's office or clinic.

 

Sometimes, TTP can come back.  Please be aware of the signs and symptoms of TTP noted earlier in this handout and call your doctor as soon as you notice any of these.

 

 

Phone Numbers

 

If you have any problems or questions once you are home, you can call:

 

Hematology Clinic:  (608) 263-7022

 

Your doctor: __________________________________________

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 05/06/2008

Copyright © 05/05/2008 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #4318

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