This is Part I of a 2-part lecture on TTP, DIC, and thrombocytopenia in the critically ill patient. It was given by Tom Deloughery at the EEMCrit Conference. The Essentials folks have a video package of the whole day at their site.
See Part II for Diagnosis
Tom DeLoughery MD, MACP, FAWM
Professor of Medicine, Pathology and Pediatrics, Divisions of Hematology/Oncology and Laboratory Medicine at Oregon Health & Science University
Tom DeLoughery is a native Hoosier who graduated from Indiana State University in 1981 (one year after Larry Bird) and the Indiana University School of Medicine in 1985. He did his internship at the University of California, Irvine before traveling to Oregon where he finished his internal medicine residency and hematology/oncology fellowship.
His clinical interests are in blood diseases, hemostasis, and thrombosis, subjects on which he has written extensively. He has won numerous teaching awards and has given education sessions to national meetings of many professional societies. He is a master at the American College of Physicians and Fellows of the Academy of Wilderness Medicine. Recently the 3rd edition of his popular handbook Hemostasis and Thrombosis was published. His one odd fact is that he has been to 40 Bob Dylan concerts in 5 countries.
Thrombotic Thrombocytopenic Purpura (TTP)
- Primary Disease
- Decreased ADAM-TS-13
- A Disease of Excess Platelet Aggregation
- Terrible Triad
- No schistocytes = no TTP
- Symptoms wax and wane
Disseminated Intravascular Coagulation (DIC)
- aka Disease-Induced Coagulopathy
- Secondary Disease
- Too much thrombin
- Thrombosis and Bleeding
- Platelet Activation
- Markedly increased D-Dimer
- Decreased Fibrinogen
- Normal Coags = No DIC
Amazing Image Above by Dr. Hanson
Now On to the Vodcast…