Thrombotic Thrombocytopenic Purpura (TTP)

Hemolytic Uremic Syndrome (HUS) is a triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure.
Thrombotic thrombocytopenic purpura (TTP) is a pentad of microangiopathic hemolytic anemia, thrombocytopenia, acute renal failure, fever, and neurological abnormalities.
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Bernard-Soulier Syndrome (BSS) is an autosomal recessive (AR) disorder characterized by a defective GP1b platelet receptor leading to a problematic platelet adhesion process (primary hemostasis).
Glanzmann Thrombasthenia (GT) is an autosomal recessive defect in the GPIIb/IIIa (GP2b/3a) receptor on the platelet which leads to defective platelet aggregation.
Ristocetin Cofactor Assay (RIPA) is usually abnormal in cases of Bernard-Soulier Syndrome (BSS).
Bleeding time is prolonged, platelets are big in size, but few in number (Macrothrombocytopenia).
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Platelet count is one of the lab tests used by a doctor or a hematologist to assess whether your platelet number is normal, low (thrombocytopenia) or high (thrombocytosis).
Bleeding 🩸 time (BT) is another test for platelet function.
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[@dayo.s2512]

Wow loved how you explain everything in details and you repeat the important things more than 1 time.

[@siddharthtrivedi320]

You made medicine super fun whilst givin proper info. Thanks . Subbed!

[@MedicosisPerfectionalis]

Thank you 🙏

[@princevegeta5968]

The unique and funny way of explaining stuff and the way tough topics are broken down into easy and digestible bits are a boon to have, before exams. Keep up God's work good sir!! Left you a like❤

[@billyghostal]

Plasmapharesis BABY!!!

[@msdreirae6401]

OMG I love this so much! thank you. i just started working in hematology after working for years in onco and ITU. I was having a hard time making patterns and organizing my studies. this extremely helps! thank you!!!!!

[@MedicosisPerfectionalis]

You're so welcome! Would you please help me by sharing?

[@jameslazib4989]

love the energy you're bringing hahah

[@MedicosisPerfectionalis]

Thank you ☺️

[@medic-9]

Love the Gordon Ramsay monologue at the end 🤣

[@ifrahakbar2878]

the gordon ramsay bit: excellent!!

[@MedicosisPerfectionalis]

Hehe

[@cjodyssey]

9:59 "i dont care nerd" will now be my response when the attending trys to pimp me

[@cheffinitupwithmrpossibili5623]

currently an img studying for my step 1 and this video gave me a much clearer understanding of TTP!

[@MedicosisPerfectionalis]

I am glad it helped! Please help me by sharing my videos with others.

[@shahabuddin6149]

Wow really you're all material is very conceptual,thanks sir keep it up,be happy and healthy forever

[@MedicosisPerfectionalis]

Thank you so much 😊

[@shreyaray5500]

Ahh this was so much fun. Where was this channel all my life!,

[@PedramV]

I was diagnosed with TTP a couple of weeks ago. Still in the hospital, but PEX got things in order (the last one was three days ago). This video was extremely helpful and helped me understand what's happening to me. Thank you! Btw, they suspect I might actually be one of those extremely rare cases of inherited TTP. Gotta start buying lottery tickets 😂

[@PedramV]

Update: ADAMTS13 Inhibitor test came back positive so at least I was getting the right treatment. And it has been working. ADAMTS13 activity is in the normal range (0.41) and platelet count has stabilized in the lower end of the normal range. So far so good!

[@salamsthoughts5842]

What are ur symptoms?

[@PedramV]

@@salamsthoughts5842 couple of bruises on the legs, a bit of confusion, and petechiae (both legs). I was feeling unwell for a few days before all of these symptoms appeared.

[@PedramV]

@@salamsthoughts5842 everything has been normal after the treatment. Platelets normalized around 160 (even though they dropped to 130 for a couple of weeks) and ADAMTS13 activity has been between 0.48 and 0.79 (doing the test every month).

[@sefagoktepe7090]

@@PedramV get well bro❤

[@Sammy.a1287]

Coombs test is negative because although the IgG antibodies are present, they are not against RBC's or platelets, they are against the enzyme which breaks down vWF.

[@aakankshapatel2192]

Genius Simplifying Work ✅✅✅✅

[@amarbhagat5798]

Data - information- knowledge- wisdom great bro💥💥💥💯💯❤️

[@MedicosisPerfectionalis]

Thank you ☺️

[@dranamika3]

Fantastic man!

[@AliKhan-sr1cm]

Keep up the great work

[@user-bn3mp9jm4i]

You are amazing thank you so much ☘️🙏🏻

[@timiahgallishaw1405]

I currently have ttp but I’m fighting I will get through this !!

[@MedicosisPerfectionalis]

Stay strong!

[@andreacanepa2560]

Loved it, thanks!

[@MedicosisPerfectionalis]

My pleasure 😇

[@mohamedelhadi4477]

my new fav channel ;)

[@MedicosisPerfectionalis]

Thank you so much 😊

[@hammerradiology1470]

Just yesterday I saw a case of TTP from a dog bite. It escalated to sepsis and internal bleeding...the lab results and images all indicate an aquired TTP. Really interesting.

[@nagatsatti8426]

Wonderful and excellent thank you doctor

[@aytakchichak7456]

marvellous...thank you

[@DinaAwd]

Loved it thank u so much 💖

[@MedicosisPerfectionalis]

My pleasure 😇

[@driffat100]

Very well explain which helps to memorise clear concepts for exam preparation ❤keep it up bro💯👍🙏

[@sarayaraddad23]

Amazing video 🙏🏻

[@MedicosisPerfectionalis]

Thank you 🙏

[@colormekubrick2757]

Hello, I just got out of the hospital after a bought with TTP. Luckily I caught it in time before it took me. I’m 44 years old. My blood counts are normal. I had about 6 sessions of plasmapheresis. Its now my second night back at home after discharge, and at night I tend to shake a little bit when lying down. Is this just my body slowly accommodating to the plasmapheresis process? I’m also on prednisone. Thank you so much.

[@kpot9357]

thank u, helpful video BTW in university, we were taught that schistocytes could never be an artifacts

[@mbimbi6157]

The Rolls-Royce of medicine indeed. 🩸

[@MedicosisPerfectionalis]

Thank you, Sir!

[@nightstar8504]

Hello, doctor I have one question. In TTP , vWf is overly active,platelets are adhered to form a thrombosis and the number of circulated free platelets decrease. In Bernard Soulier disease vWf is normal but receptor is inactive. It doesn't adhere to form thrombosis. So,they should be circulated freely through the bloodstream .But why ,platelet number decrease instead of increasing ?

[@McMedLife]

Great question! From my understanding, lack of GP1b also leads to the platelets being abnormally shaped in Bernard-Soulier syndrome (i.e. "Giant platelet cells") and, as you mentioned, since they are freely circulating in the bloodstream due to lack the ability for adhesion, they are also subject to shearing forces, leading to further shape irregularities. This, combined with their increased freely circulating quantity leads to detection by the immune system and hence the their destruction and clearance by the immune system.

[@drsamkitshah6177]

Excellent!!!!!!

[@MedicosisPerfectionalis]

Thanks 🙏

[@s.u.k.k.u8765]

I thought i will watch the pathology of TTP only and skip the rest video…but crap i got Stuck 😂😂😂 Your videos are extremely helpful n fun to watch. 🙂

[@MedicosisPerfectionalis]

Thank you 🙏

[@drbonfire]

"you need to know what the flip you are talking about" hahaha fortunately that is the reason I am here good sir

[@MedicosisPerfectionalis]

Thank you so much for watching 😊

[@drbonfire]

@@MedicosisPerfectionalis Thank you for making the video! We have our heme/onc/cardio/renal/pulm exam coming up (yes, our deans did that 🤪) and I am about to be the biggest fan of the heme/onc playlist!!

[@MedicosisPerfectionalis]

Good luck 🍀 to you, dear :)

[@kennedychisenga4001]

Glad I've come to know you

[@MedicosisPerfectionalis]

Thank you! I am honored!

[@al-qira8596]

Amazing Keep up journey

[@nimrafaraz2549]

Wow, I wish to be amazing like this medicosis guy superb🎉

[@MedicosisPerfectionalis]

Thank you so much!

[@codrut913]

This guy is funny and very good !!!

[@MedicosisPerfectionalis]

Thank you so much 😊

[@MedicosisPerfectionalis]

☺️☺️

[@deepakb6517]

Fever and neurological symptoms(AMS)

[@hello-un8gh]

Great video! Unlike many professors you explain in a clear and simple way! In this regard, I was told that in TTP, unlike DIC, there is no hemorrhagic risk and the purpura is due to blood extravasation following endothelial damage due to ischemia caused by the formation of microthrombi. But i was wondering...Isn't poropra a result of thrombocytopenia? Furthermore, shouldn't thrombocytopenia (

[@MedicosisPerfectionalis]

Great question! There might be a hemorrhagic risk, but it really depends on how low the platelet count. A person with a platelet count of 4,000 is a completely different story than a patient with a platelet count of 48,000. Also, we have to take the coagulation factors into consideration. Platelets usually protect us from superficial bleeding, whereas the coagulation factors protect us from deep tissue bleeding (e.g. internal bleeding). Hope that helps!

[@roshnyjacob5493]

amazing videos. Do you talk on histopathology topics?

[@MedicosisPerfectionalis]

Unfortunately, not yet!

[@roop502]

Wonderful!!!!!

[@MedicosisPerfectionalis]

Thank you 🙏

[@pinkrose9594]

Mo Salah of medicine 🔝🔝

[@MedicosisPerfectionalis]

Thank you ☺️

[@marciadorsey3974]

he cracks me up

[@MedicosisPerfectionalis]

Thank you 😊

[@sydalg95]

9:56 😂 I had this aquired ttp as a kid about 20 yr ago just wanted to understand it a bit better for some reason this morning. It went dormant without treatment if i am recalling correctly? The doctors back then thought it was lukemia for a short period before figuring out it was TTP. Scary stuff thanks for the laugh!

[@marzena888888]

Where do the neurologic symptoms and fever come from? I have watched the video carefully and loved it, but I don't really get the reasons for these additional symptoms

[@MedicosisPerfectionalis]

It’s a systemic pathophysiological process that can affect anything. Statistically, some symptoms are more common than others, but I don’t know why.

[@bitterguard5233]

Neurological symptoms due to microembolic occlusion probably

[@srinivasaraosirasapalli5104]

Excellent

[@MedicosisPerfectionalis]

Thank you 🙏

[@user-tr6qz4id8z]

Amazing 😍😍

[@LeeMinhoNepal]

I want to know how you make such videos. Writing and making pictures too. always explained best.

[@ABC-fv7ow]

Nicely explained.Since TTP is intravascular hemolysis,then why splenomegaly in it?Pls answer

[@SixthKiller]

To increase the plt count. This is no longer applicable.

[@DucTapeDino]

Im pretty sure its because you are getting Schistocytes from the platelet microthrombi that is being formed in TTP. Its shearing the rbcs as they come along and so now that they are effected/damaged, the spleen filters them out which causes the spleen to overwork leading to work induced hyperplasia. i.e. splenomegaly.

[@DucTapeDino]

Or it could be what SixthKiller is saying and just extramedullary hematopoesis occurring due to the loss of platelets but i dont rlly believe that since there is no hepatomegaly.

[@stanleyigbinosa1952]

This is medicosis, the Rolls Royce of medicine 😂❤

[@afridi3dart17]

Hhhh as you educating others as well as you bringing smile 🙂🙂😁 also the way you are teaching wooooww and you also making question from yourself and answering too

[@MedicosisPerfectionalis]

Thank you 😊

[@afridi3dart17]

@@MedicosisPerfectionalis i was my assignment and watching many videos but at least I found it at your channel and hence completed my assignment 🙂🙂☺️ love you

[@Tumi_2000]

OMG I was so going "its 76 to 100" on the MCV😂😂

[@mekdadhassan4282]

Amazing vedio 🌹

[@MedicosisPerfectionalis]

Thank you 🙏

[@jacintovski]

I think you made small a mistake. Shouldn't the location of the gene 9q34 be read "chromossome 9, long arm, region 3, band 4" instead of "chromossome 9, long arm, region 34"?

[@user-tx9ci1xy2r]

amazing! thank you.. I loved it .. but if you could please speak much more slowly.. I'm getting lost sometimes 🥺

[@heatherrotz3388]

change the playback speed to 0.75!

[@DucTapeDino]

Awkward Im over here wishing 3x speed was as option 😂😂😂.

[@sathakamara1324]

What's with the purple cat at the end?

[@msbzamalek]

Great 👍

[@MedicosisPerfectionalis]

Thank you! Would you please help me by sharing?

[@AliHamza-bz2oo]

Why fever occurs in ttp plz explain

[@Moosemoose1]

I have a question: if the inhibitor of the ADAMST13 gene is IgG, why isn't TTP considered an immune disorder?

[@ahmedrashwan7250]

It is actually considered immune disorder and ttt is prednisone for that cause

[@Moosemoose1]

@@ahmedrashwan7250 ah, then what would differentiate it from ITP in that case?

[@ahmedrashwan7250]

@@Moosemoose1 I asked myself the same question and the answer is that ITP is a no platelet thing but TTP is crazy platelets the forms thrombosis every where causeing micro angiopathic hemolysis of r.b.cs and stuff like that

[@udithaudumulla1139]

So funny ..thank you ❤️

[@kingstonfreeman9309]

it was very scary this is sierous

[@eltonfredy8558]

I'm waiting for your explanation about DIC 😁😁

[@MedicosisPerfectionalis]

Coming soon

[@bellenaval784]

hi do you have document for these?

[@MedicosisPerfectionalis]

Hey 👋 Belle, How are you? What do you mean by “document”?

[@fidelia5937]

I have 2 boys and now my baby girl husband and I are carriers..... But no matter what science says nothing is impossible for God Doctors are always surprise how my boy body react prayers are so powerful never stop believing God is amazing and always can do miracle's TTP🔗chain breakers Philippians 4:13🙏❤ thank you Dr beautiful explained

[@kitydr86]

Amin

[@deepakg4623]

My baby 5 manth old TTP

[@mandisangema2568]

LOL! The Rolls Royce of Medicine

[@MedicosisPerfectionalis]

😂😂 It’s true 😊😊

[@user-ik6if1co2j]

Why there is hemolysis i could not get it. Plz help

[@123456789suarez]

Due to the deposition of microthrombi in the small vessels, the lumen becomes narrower. RBCs try to squeeze through the narrowed lumen....and it goes boom

[@brewedmeditation2886]

Upshaw Schulman syndrome. Very difficult name for Bengali

[@jamalimurtaza6527]

❤

[@stellarose4854]

My brother is in hospital with this he is only 12 please give me hope

[@sydalg95]

I'm 29 I had it when I was younger than your brother

[@sydalg95]

It rarely even crosses my mind this many years later

[@abdou.b3259]

There is no fever

[@drvivekpratap]

Gr8

[@MedicosisPerfectionalis]

Thank you!

[@mhuraic]

Why is there a fever in TTP?

[@billybarker3064]

I have TTP. 7 episodes. Not a single fever.

[@sofacitysounds947]

Never had a fever either. 1 episode...super severe though

[@SixthKiller]

I am with ttp and I had a massive sweating all the time. Today was my second plasmapheresis.

[@doc1780]

Fever and no bloody diarrhea !

[@shamisomushayi1486]

Rolce Roy's medicine

[@MedicosisPerfectionalis]

😊😊😊

[@rahmahl5762]

I don’t get the answer ☹️☹️

[@rahmahl5762]

AKI + Thrombocytopenia? 😕

[@rahmahl5762]

Yuppp I’ve already watched the next video It’s MAHA + thrombocytopenia 🤭

[@mohammedimam2412]

Can u make an Arabic translate for your videos?

[@MedicosisPerfectionalis]

I would love to, but it will take so much time. Sorry!

[@grmnsmith145]

My mom died from this

[@MedicosisPerfectionalis]

I am so sorry!

[@sonysanaka6056]

Hello telugu lo explain chIagalaru

[@abdirahmangulled8128]

You're goated 😂

[@MedicosisPerfectionalis]

What does that mean?! 😅

[@user-ux7eo1eb3n]

AKI & MAHA?🙈

[@MedicosisPerfectionalis]

Nope

[@user-ux7eo1eb3n]

😁How come?!

[@user-ux7eo1eb3n]

Thrombocytopenia is too nonspecific, it is present in HELLP and DIC. The last two criteria (fever & mental status changes) do not work for HUS, only for TTP...

[@Yottifferent]

Here bc J Dilla died from this

[@toufytaylorsversion8700]

you are so fast slow down a bit

[@MedicosisPerfectionalis]

Got it...Thanks!

[@douglasthescottishtwin3989]

Tehrik-i-Taliban Pakistan is TTP

[@Divinelyloved_2024]

Slow down with explanation

[@ebisinecarlmaristobi8842]

Hello, your teaching is really nice but you talk really fast it would be nice to tone down your pace. Thank you

[@motomoto898]

Excellent. Thank you.

[@MedicosisPerfectionalis]

My pleasure 😇