13
Statement 10
➤ We did not systematically search and review the evidence on long-
term complications of TTP. In patients that have recovered from a
prior acute TTP episode, the panel acknowledged the importance of
monitoring for the development of mood disorders, neurocognitive
symptoms (including short term memory issues), and hypertension
that may develop during remission, independent of a new acute TTP
episode. Specific recommendations regarding screening cannot
be made at this time, but serial follow-up and monitoring for these
issues may be considered part of routine long-term follow-up.
Statement 11
➤ We did not systematically search and review the evidence on the
role of support groups for TTP patients. Health care providers may
consider offering patients with TTP professional online resources
and/or support groups for this rare disease. A number of established
support groups exist for individuals with TTP who are going through
or have gone through similar experiences. These are listed in Table
1.
SECTION II. Relapse Prevention
➤ In this section, the panel provides statements pertaining to relapse
prevention beyond what has provided in Recommendations 3 to 5.
Statement 12
➤ We did not systematically review the evidence on triggers for relapse.
However, a number of potential triggers for relapse have been
suggested in patients with TTP who have achieved clinical remission.
Any illness or a special health condition can trigger a relapse,
however the most commonly discussed triggers include:
• Infections, including influenza, community acquired pneumonia, periodontal and
dental infections, and gastroenteritis
• Pregnancy
• Major trauma or surgery
• Intake of oral contraceptives
• Cocaine and other recreational drugs
• Intake of other drugs including quinine, ticlopidine, clopidogrel, cyclosporine, and
tacrolimus
• Pancreatitis
➤ Clinicians usually counsel patients on triggers for relapse, and
encourage them to seek medical attention for concerning signs and
symptoms of any illness.
