Thrombotic thrombocytopenic purpura (TTP) presenting as pancreatitis

Myocardial injury in thrombotic thrombocytopenic purpura: A frequent, perplexing complication

“…Indisputably, negligible cTnI elevations should not be treated and targeted therapy should be reserved for cases where cardiac dysfunction arises; however, the use of thrombolytics and anticoagulants involves an amplified risk of bleeding owing to thrombocytopenia, but platelet transfusions lead to rapid deterioration [23]. Reports linking ticlodipine and clopidogrel with a high incidence of TTP limit their use [24,25] and adding aspirin or dipyridamole to PE and steroids does not impact mortality [26].…”

Thrombotic Microangiopathy in a Child With Acute Pancreatitis

“…The response rate was about 80% (26). The other therapeutic options in TTP were steroids, intravenous immunoglobulins, vincristine, antiplatelet agents, splenectomy and rituximab (15,21,27). In AP, all the patients who received FFP survived, with or without plasmapheresis, whereas a patient died on corticotherapy (5).…”

“…Moreover, we would like to emphasize that it is important to avoid platelet infusion, which can lead to a rapid deterioration (11,28). Finally, platelet count is the most useful parameter to monitor this disorder (15).…”

The Clinical Spectrum of Thrombotic Thrombocytopenic Purpura

“…In contrast, acute pancreatitis may be the first manifestation of TTP presenting as acute abdominal pain. 41 Of interest is the older concept found in the published literature that acute pancreatitis may trigger TTP. [41][42][43][44][45] However, in light of the current understanding of the pathogenesis of TTP, it is unlikely that this is the sequence of events.…”