The Bottom Line: Life-threatening ARDS can be associated with TTP. Early recognition of ARDS associated with TTP and timely EP is critical to a favorable outcome.
Summary: Experience suggests that ARDS may occur as a clinical feature of either de novo or secondary TTP; therefore, all patients with ARDS should be evaluated for unrecognized TTP. A high index of suspicion is crucial when a patient with ARDS presents with unexplained thrombocytopenia and MAHA, with or without neurological or mental changes. Because exchange plasmapheresis is a life-saving measure, unexplained thrombocytopenia and MAHA should be sufficient criteria to make the presumptive diagnosis of TTP for the initiation of exchange plasmapheresis.
Reference: Chang JC, Aly ES. Acute respiratory distress syndrome as a major clinical manifestation of thrombotic thrombocytopenic purpura. Am J Med Sci. 2001 Feb;321(2):124-8.