De-novo immune-mediated thrombotic thrombocytopenic purpura following surgical and non-surgical procedures: A systematic review

• Published in: Blood reviews Vol. 66; p. 101197
• Main Authors: Pinheiro Maux Lessa, Morgana, Soares Ferreira Junior, Alexandre, Graton, Margaret, Simon, Erin, Ledbetter, Leila, A. Onwuemene, Oluwatoyosi
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.07.2024
• Subjects: Etiology; Humans; Immune thrombotic thrombocytopenic purpura; Precipitating factors; Purpura, Thrombotic Thrombocytopenic - diagnosis; Purpura, Thrombotic Thrombocytopenic - etiology; Purpura, Thrombotic Thrombocytopenic - therapy; Surgical procedures; Surgical Procedures, Operative - adverse effects; Immune thrombotic thrombocytopenic purpura; Surgical procedures; Etiology; Precipitating factors
• ISSN: 0268-960X; 1532-1681; 1532-1681
• DOI: 10.1016/j.blre.2024.101197

When de-novo immune-mediated thrombotic thrombocytopenic purpura (TTP) is diagnosed following an invasive procedure, clinical presentation patterns and outcomes are poorly defined. Therefore, in a systematic literature review of patients diagnosed with TTP following an invasive surgical or non-surgical procedure, we identified 19 studies reporting data on 25 patients. These data suggest that 1) TTP pathogenesis likely begins prior to the invasive procedure, 2) patients experience significant diagnostic delays, and 3) there is a high incidence of renal replacement therapy. Although invasive procedures may trigger TTP, further studies are needed to clarify the mechanisms underlying this association. •Surgical and non-surgical procedures may act as a trigger for active TTP.•Based on tissue and blood samples, TTP pathogenesis likely precedes the procedure.•Following an invasive procedure, the TTP diagnosis is often delayed.•These patients often experience a high incidence of renal replacement therapy.