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Comparison of frequency of signs, symptoms, and laboratory findings in TTP, HUS, HELLP, and AFLP

Comparison of frequency of signs, symptoms, and laboratory findings in TTP, HUS, HELLP, and AFLP
  TTP HUS HELLP AFLP
Abdominal pain ++ ++ ++ ++
Low ADAMST13 activity +/++ – –/+ ?
Anemia ++ ++ + +
Elevated lactic dehydrogenase ++ very high values ++ very high values ++ +/++
Elevated transaminases –/+ –/+ ++ ++
Fever + – – +
Headache or visual disturbance ++ – ++ –/+
Hypertension +/++ ++ ++ –
Jaundice – – + +
Nausea and vomiting ++ ++ ++ ++
Proteinuria + and hematuria ++ ++ –
Thrombocytopenia ++ ++ ++ +
von Willebrand factor ++ ++ – ?
Hypoglycemia – – –/+ ++
TTP: thrombotic thrombocytopenic purpura; HUS: hemolytic uremic syndrome; HELLP: hemolysis, elevated liver function tests, low platelets; AFLP: acute fatty liver of pregnancy; +: prevalence of finding in affected patients.
Adapted from:
  1. Stella CL, Dacus J, Guzman E, et al. The diagnostic dilemma of thrombotic thrombocytopenic purpura/hemolytic uremic syndrome in the obstetric triage and emergency department: lessons from 4 tertiary hospitals. Am J Obstet Gynecol 2009; 200:381. Original Table 4.
  2. Pourrat O, Coudroy R, Pierre F. Differentiation between severe HELLP syndrome and thrombotic microangiopathy, thrombotic thrombocytopenic purpura and other imitators. Eur J Obstet Gynecol Reprod Biol 2015;189:68. Table 1.
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