Incidence of Thrombotic Thrombocytopenic Purpura/Hemolytic Uremic Syndrome

Abstract

The incidence of thrombotic thrombocytopenia purpura and hemolytic uremic syndrome is higher than previously reported but does not appear to be rising. Apparent international differences in incidence could be the result of imprecision in identifying thrombotic thrombocytopenia purpura and hemolytic uremic syndrome in large research databases.

New‐onset and idiopathic thrombotic thrombocytopenic purpura: Incidence, diagnostic validity, and potential risk factors

“…Our results differ from Miller et al [10], who found a higher incidence of TTP in the United States than previously reported, but did not find an increase in the rate of TTP over time. However, our results are consistent with To¨ro¨k et al [9], who found an increasing trend in the incidence of TTP from 0.4 to 1.1 per million per year during 1970 to 1991.…”

“…Although our incidence rate of TTP is lower than the rate of 3.7 per million persons reported by To¨ro¨k et al [9] and the rate of 3.8 per million person-years reported by Miller et al [10], there are a number of exclusion criteria that could account for the lower incidence rate found in our study. First, and most importantly, our analysis was restricted to those younger than 65 years while the studies of To¨ro¨k et al [9] and Miller et al [10] reported rates for the population at large (i.e., all ages). These two studies-and ours-suggest that the rate of TTP increases with age.…”

“…The results of our study suggest that administrative claims data may be useful for identifying drug exposures and comorbidities potentially associated with TTP. Two patients were taking medications known to be cytotoxic (cyclosporine, sirolimus), but several other patients were prescribed medications (omeprazole, sulfamethoxazole/trimethoprim, and conjugated estrogen) that have been described in association with TTP [10]. However, as a case series and without a control group or mechanism for adjustment, our study does not support any association between these agents and TTP.…”

“…The exact incidence rate of TTP is unknown, but a landmark study by To¨ro¨k et al [9] estimated an annual incidence of 3.7 cases per million. A more recent study by Miller et al reported an incidence of 3.8 per million-person years [10]. Research by Terrell et al further classified cases of TTP-hemolytic ure-mic syndrome (HUS) into three categories, with the following incidence rates: 11.3 per million for all patients with clinically suspected TTP-HUS, 4.5 per million for idiopathic TTP-HUS, and 1.7 per million for patients with severe ADAMTS13 deficiency [11].…”

Angka Kejadian Koagulasi Intravaskular Diseminata pada Pneumonia

“…Oleh karena angka kejadian TTP yang rendah (prevalensi TTP di Amerika tahun 2004 adalah 6,5/1.000.000 kejadian per tahun) dan angka kejadian KID yang tinggi (insidens KID tahun 2004 di Jepang 1,72% dan di Turki 1% per tahun), maka penelitian kami hanya difokuskan untuk mencari kejadian KID sebagai bentuk trombosis sistemik yang terjadi. [4][5][6] Selain itu, tata laksana yang agresif dilakukan pada pasien dengan KID dekompensasi maka penelitian hanya difokuskan untuk mencari kejadian KID fase dekompensasi. Diharapkan penelitian kami dapat membuat para dokter lebih waspada terhadap terjadinya KID pada pasien pneumonia.…”