Last reviewed: November 2017
Last updated: October  2017

Summary

Definition

History and exam

Key diagnostic factors

  • nonspecific prodrome
  • severe neurologic symptoms (coma, focal abnormalities, seizures)
  • mild neurologic symptoms (headache, confusion)
  • fever

Other diagnostic factors

  • age 30 to 50 years
  • digestive symptoms (nausea, vomiting, diarrhea, abdominal pain)
  • weakness
  • bleeding symptoms (purpura, ecchymosis, menorrhagia)

Risk factors

  • black ethnicity
  • female gender
  • obesity
  • pregnancy (near term or postpartum period)
  • cancer therapies
  • HIV infection
  • bone marrow transplantation
  • antiplatelet agents
  • quinine

Diagnostic investigations

1st investigations to order

  • platelet count
  • hemoglobin
  • haptoglobin
  • peripheral smear
  • reticulocyte count
  • U/A
  • BUN and creatinine
  • direct Coombs test
Full details

Investigations to consider

  • ADAMTS-13 activity assay and inhibitor titers
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Associate Professor of Medicine

Division of Hematology and Medical Oncology

The University of Tennessee Health Science Center

Memphis

TN

Disclosures

SKR has received honoraria, speaker's fees, consultancy fees, and research support from Alexion Inc., Biogen, Octapharma, Baxalta, and Kedrion.

Dr Sandeep K. Rajan would like to gratefully acknowledge Dr Rebecca Fischer Connor, a previous contributor to this monograph. RFC declares that she has no competing interests.

Peer reviewers VIEW ALL

George Lynn Cross Professor

Department of Biostatistics and Epidemiology

University of Oklahoma Health Sciences Center

Oklahoma City

OK

Disclosures

JNG declares that he has no competing interests.

Associate Professor of Medicine

Department of Internal Medicine

Innsbruck Medical University

Innsbruck

Austria

Disclosures

CP declares that he has no competing interests.

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