What are the clinical consequences of cTTP?

The clinical presentation ranges from life-threatening, acute, overt TTP events to milder TTP manifestations, including thrombocytopenia, haemolytic anaemia, abdominal pain, headaches, and neurological symptoms.¹ End-organ damage due to recurrent overt and non-overt TTP events, such as stroke, chronic kidney disease, or cardiac involvement, can develop.¹
 

As well as acute events, ongoing subacute manifestations of cTTP can also occur despite the absence of typical clinical and laboratory findings.^1,2 Symptoms of subacute cTTP can include lethargy, headaches, migraines and abdominal pain. It is important for clinicians to be aware of these manifestations as they may indicate underlying disease.³ Additionally, over time, cTTP can result in long-term neurological, cardiovascular, or renal complications.¹ Retrospective data has shown that patients with TTP have a higher mortality rate as compared to the general population.⁴ This suggests that TTP should be viewed as a chronic disease with acute events.^5,6
 

In a study integrating inputs from a literature review, expert opinions, and patient interviews, patients interviewed by telephone indicated that the most salient impacts of cTTP were the diminished ability to work/study, financial distress, feeling depressed, feeling anxious, and mood swings.⁷

In practice, the signs and symptoms associated with cTTP are highly complex and can vary widely between patients.^1,8 They can range from asymptomatic disease, to a single episode and chronic-relapsing forms, and multiorgan failure.^1,8 An increased awareness of the clinical manifestations of cTTP, including patient-reported outcomes, is important in order to provide adequate short-term and long-term treatment.⁸