Abstract
The outcomes and characteristics of acquired thrombotic thrombocytopenic purpura (TTP)
in adolescents is poorly understood due to an absence of studies focused on this population.
To better understand the life-threatening disorder in this age, we performed an analysis
of adolescent patients (ages 10–21) with TTP in the Pediatric Health Information Systems
database from 2009 to 2020. The primary outcomes evaluated were in-hospital mortality
and rate of TTP relapse. Secondary outcomes included rates of hemorrhagic and thrombotic
complications during hospitalizations for TTP. Patients were included if they had
a thrombotic microangiopathy diagnostic code, ADAMTS13 lab obtained, and received
therapeutic plasmapheresis. Patients that received treatment for other non-TTP microangiopathies
were excluded. A total of 99 patients with 123 hospitalizations for TTP treatment
were identified. In-patient mortality occurred in 6 % (n = 6) and TTP relapse in 20 % (n = 20) of the cohort. Median time from initial admission to relapse was 33 days (IQR
15, 92). A hemorrhagic complication was identified in 29 % (n = 36) and thrombotic complication in 15 % (n = 19) of the cohort. The presence of underlying comorbidities was not associated
with TTP relapse and only a diagnosis of cancer was associated with increased mortality.
The rate of mortality and relapse in adolescent TTP is lower than that seen in adult
registries. Long term prospective studies are needed to understand the long-term consequences
of adolescent onset acquired TTP.
Keywords
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Article info
Publication history
Published online: December 21, 2022
Accepted:
December 15,
2022
Received in revised form:
December 14,
2022
Received:
October 17,
2022
Footnotes
☆The data that support the findings of this study are available from the corresponding author upon reasonable request.
☆No funding was received for this study; the authors have no competing interests to declare.
☆The authors have no relevant conflicts of interest to disclose relevant to this study
☆Institutional Board Review approval was not obtained due to the use of a deidentified publicly available database
☆Data contained in the manuscript were presented at the International Society of Thrombosis and Haemostasis 2022 Congress.
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