Thread by @HermelinMD, MaternalFetalMedicine #Blooducation conference. Topic: #TTP in pregnancy. We focused on thrombotic microangiopathic [...]

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤰🏽" title="Schwangere Frau (mittlerer Hautton)" aria-label="Emoji: Schwangere Frau (mittlerer Hautton)">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤰🏼" title="Schwangere Frau (mittelheller Hautton)" aria-label="Emoji: Schwangere Frau (mittelheller Hautton)">

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤰🏿" title="Schwangere Frau (dunkler Hautton)" aria-label="Emoji: Schwangere Frau (dunkler Hautton)">MaternalFetalMedicine #Blooducation conference. Topic: #TTP in pregnancy. We focused on thrombotic microangiopathic hemolytic anemias &

https://abs.twimg.com/emoji/v2/... draggable="false" alt="✂️" title="Schere" aria-label="Emoji: Schere">shear wonder of the #schistocyte. Rock, Paper, Scissors, Shoot. Let& #39;s recap on the some of the topics.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="👇🏼" title="Rückhand Zeigefinger nach unten (mittelheller Hautton)" aria-label="Emoji: Rückhand Zeigefinger nach unten (mittelheller Hautton)">Follow the Tweetorial below

A 23 y/o G2P1 pregnant woman presents to the MFM clinic at 19 weeks gestation. She complained of intermittent headaches and feeling "more tired."

https://abs.twimg.com/emoji/v2/... draggable="false" alt="😱" title="Vor Angst schreiendes Gesicht" aria-label="Emoji: Vor Angst schreiendes Gesicht">BP is 220/110!
Cr = 3.25, Hb/Hct = 5.4/18.6 Plt = 40

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🔎" title="Nach rechts zeigende Lupe" aria-label="Emoji: Nach rechts zeigende Lupe">Notice the #schistocytes on her peripheral smear below

A 23 y/o G2P1 pregnant woman presents to the MFM clinic at 19 weeks gestation. She complained of intermittent headaches and feeling "more tired." https://abs.twimg.com/emoji/v2/... draggable=

BP is 220/110! Cr = 3.25, Hb/Hct = 5.4/18.6 Plt = 40https://abs.twimg.com/emoji/v2/... draggable="false" alt="🔎" title="Nach rechts zeigende Lupe" aria-label="Emoji: Nach rechts zeigende Lupe">Notice the #schistocytes on her peripheral smear below" title="A 23 y/o G2P1 pregnant woman presents to the MFM clinic at 19 weeks gestation. She complained of intermittent headaches and feeling "more tired." https://abs.twimg.com/emoji/v2/... draggable="false" alt="😱" title="Vor Angst schreiendes Gesicht" aria-label="Emoji: Vor Angst schreiendes Gesicht">BP is 220/110! Cr = 3.25, Hb/Hct = 5.4/18.6 Plt = 40https://abs.twimg.com/emoji/v2/... draggable="false" alt="🔎" title="Nach rechts zeigende Lupe" aria-label="Emoji: Nach rechts zeigende Lupe">Notice the #schistocytes on her peripheral smear below" class="img-responsive" style="max-width:100%;"/>

Which of the following conditions can #schistocytes be found?

You got it! #Schistocytes are a RBC abnormality that can be seen in a number of conditions, and are caused by

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🔨" title="Hammer" aria-label="Emoji: Hammer">mechanical destruction of the RBC. In thrombotic microangioapathies (TTP/HUS), #Schistocytes are formed when

https://abs.twimg.com/emoji/v2/... draggable="false" alt="✂️" title="Schere" aria-label="Emoji: Schere">sheared through microthrombi formed in small vessels.

You got it! #Schistocytes are a RBC abnormality that can be seen in a number of conditions, and are caused by https://abs.twimg.com/emoji/v2/... draggable=

mechanical destruction of the RBC. In thrombotic microangioapathies (TTP/HUS), #Schistocytes are formed when https://abs.twimg.com/emoji/v2/... draggable="false" alt="✂️" title="Schere" aria-label="Emoji: Schere">sheared through microthrombi formed in small vessels." title="You got it! #Schistocytes are a RBC abnormality that can be seen in a number of conditions, and are caused by https://abs.twimg.com/emoji/v2/... draggable="false" alt="🔨" title="Hammer" aria-label="Emoji: Hammer">mechanical destruction of the RBC. In thrombotic microangioapathies (TTP/HUS), #Schistocytes are formed when https://abs.twimg.com/emoji/v2/... draggable="false" alt="✂️" title="Schere" aria-label="Emoji: Schere">sheared through microthrombi formed in small vessels.">

#TTP is a type of disease known as a thrombotic microangiopathy (TMA). It is a condition in which microthrombi form, leading to PLT consumption (thrombocytopenia). When this occurs RBCs are fragmented & become hemolyzed as they travel through microvessels. Organ failure ensues.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="⁉️" title="Ausrufe-Fragezeichen" aria-label="Emoji: Ausrufe-Fragezeichen">How is TTP diagnosed?

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🙌🏼" title="Raising hands (mittelheller Hautton)" aria-label="Emoji: Raising hands (mittelheller Hautton)">You got it! TTP is a hereditary or acquired condition that is defined by a severe deficiency (<10%) in ADAMTS13 enzyme, which is responsible for cutting von Willebrand factor into short multimers. The acquired forms are caused by an Ab directed against the enzyme.

You got it! TTP is a hereditary or acquired condition that is defined by a severe deficiency (<10%) in ADAMTS13 enzyme, which is responsible for cutting von Willebrand factor into short multimers. The acquired forms are caused by an Ab directed against the enzyme." title="https://abs.twimg.com/emoji/v2/... draggable="false" alt="🙌🏼" title="Raising hands (mittelheller Hautton)" aria-label="Emoji: Raising hands (mittelheller Hautton)">You got it! TTP is a hereditary or acquired condition that is defined by a severe deficiency (<10%) in ADAMTS13 enzyme, which is responsible for cutting von Willebrand factor into short multimers. The acquired forms are caused by an Ab directed against the enzyme." class="img-responsive" style="max-width:100%;"/>

ADAMTS13 results is not always available with a rapid turn around time, thereofre, it is extremely useful to use the #PLASMIC score to assess who might benefit from early initiation of plasma exchange while awaiting ADAMTS13 results. https://www.mdcalc.com/plasmic-score-ttp">https://www.mdcalc.com/plasmic-s...

PLASMIC Score for TTP - MDCalc

The PLASMIC Score for TTP predicts ADAMTS-13 deficiency in suspected TTP with high discrimination.

https://www.mdcalc.com/plasmic-score-ttp

#TherapeuticPlasmaExchange is considered first line therapy for

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🥇" title="Goldmedaille" aria-label="Emoji: Goldmedaille">TTP, and benefits the patient is 2 ways:

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🔁" title="Nach rechts und links zeigende Pfeile in offenem Kreis im Uhrzeigersinn" aria-label="Emoji: Nach rechts und links zeigende Pfeile in offenem Kreis im Uhrzeigersinn">Removes patient& #39;s plasma - removes the autoantibody

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🔁" title="Nach rechts und links zeigende Pfeile in offenem Kreis im Uhrzeigersinn" aria-label="Emoji: Nach rechts und links zeigende Pfeile in offenem Kreis im Uhrzeigersinn">Adds donor plasma - add ADAMTS13

https://abs.twimg.com/emoji/v2/... draggable="false" alt="👍🏼" title="Thumbs up (mittelheller Hautton)" aria-label="Emoji: Thumbs up (mittelheller Hautton)">Great news - it is safe in pregnancy!

#TherapeuticPlasmaExchange is considered first line therapy for https://abs.twimg.com/emoji/v2/... draggable=

Pregnancy is the most common trigger of adult-onset congenital TTP, and prophylactic treatment is associated with better outcomes. http://www.bloodjournal.org/content/133/15/1644http://www.bloodjournal.org/content/133/15/1644">https://www.bloodjournal.org/content/1...

Pregnancy is the most common trigger of adult-onset congenital TTP, and prophylactic treatment is associated with better outcomes. https://www.bloodjournal.org/content/1...

At the end of our discussion, a great question was posed.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤔" title="Denkendes Gesicht" aria-label="Emoji: Denkendes Gesicht">Is it possible that pregnant patients diagnosed with HELLP who don& #39;t recover postpartum, have undiagnosed TTP?
Any additional pearls or experiences, please share below.

https://abs.twimg.com/emoji/v2/... draggable="false" alt="🙏🏼" title="Folded hands (mittelheller Hautton)" aria-label="Emoji: Folded hands (mittelheller Hautton)">Thank you!

At the end of our discussion, a great question was posed. https://abs.twimg.com/emoji/v2/... draggable=

Is it possible that pregnant patients diagnosed with HELLP who don& #39;t recover postpartum, have undiagnosed TTP? Any additional pearls or experiences, please share below. https://abs.twimg.com/emoji/v2/... draggable="false" alt="🙏🏼" title="Folded hands (mittelheller Hautton)" aria-label="Emoji: Folded hands (mittelheller Hautton)">Thank you!" title="At the end of our discussion, a great question was posed. https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤔" title="Denkendes Gesicht" aria-label="Emoji: Denkendes Gesicht">Is it possible that pregnant patients diagnosed with HELLP who don& #39;t recover postpartum, have undiagnosed TTP? Any additional pearls or experiences, please share below. https://abs.twimg.com/emoji/v2/... draggable="false" alt="🙏🏼" title="Folded hands (mittelheller Hautton)" aria-label="Emoji: Folded hands (mittelheller Hautton)">Thank you!" class="img-responsive" style="max-width:100%;"/>

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