Recognizing thrombotic thrombocytopenic purpura beyond the pentad.

Authors

• Olivia M. Pupiec, Corewell Health East Resident
• Julie R. Levin, Corewell Health East
• Christopher N. Cooley, Corewell Health East
• Diane Paratore, Corewell Health East

Document Type

Article

Publication Date

9-14-2026

Publication Title

Oxford medical case reports

Abstract

Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening hematologic disorder characterized by widespread microvascular thrombosis. Classic clinical features include: fever, microangiopathic hemolytic anemia, thrombocytopenia, renal dysfunction, and neurologic abnormalities, such as altered mental status, confusion, or coma. Prompt recognition and initiation of plasma exchange therapy in the emergency department (ED) are essential for patient survival. We report a case of a 40-year-old female who presented to the ED with a vague complaint of joint pain and no remarkable findings on physical examination. Despite the absence of hallmark features, further evaluation revealed a diagnosis of TTP. This case underscores the diagnostic challenge posed by atypical TTP presentations and highlights the importance of maintaining a high index of suspicion, even in the absence of classic clinical signs.

Volume

2026

Issue

9

First Page

omag168

Recommended Citation

Pupiec OM, Levin JR, Cooley CN, Paratore D. Recognizing thrombotic thrombocytopenic purpura beyond the pentad. Oxf Med Case Reports. 2026 Sep 14;2026(9):omag168. doi: 10.1093/omcr/omag168. PMID: 42741766

DOI

10.1093/omcr/omag168

ISSN

2053-8855

PubMed ID

42741766