VPB0311 - Thrombotic Thrombocytopenic Purpura mimicking acute Ischemic stroke

Background: Thrombotic thrombocytopenic purpura (TTP) is an autoimmune disorder characterized by thrombocytopenia, hemolytic anemia, fluctuating neurological deficits, fever and renal impairment. Differentiation of TTP from ischemic stroke is extremely important as management is entirely different. Here we report a series of patients with TTP who presented with expressive aphasia, hemiparesis and altered sensorium.

Aims: TTP and acute ischemic stroke need to be differentiated in view of differences in management, complex management strategy for TTP and high morbidity and mortality due to delays in diagnosis with TTP.

Methods: Here we present the data of 3 patients who were admitted with symptoms mimicking an acute stroke. Data was collected from hospital case records and tabulated.

Results: The profile is depicted in the table below:

Conclusion(s): TTP is a life threatening condition and has to be one of the differential diagnosis when a patient presents with altered sensorium and neurological features like ischemic stroke. Early identification and initiation of Plasmapheresis is extremely important Delay in treatment increases mortality significantly. Simple peripheral smear examination will give a clue to excluding or suspecting TTP.