Clinical observation of thrombotic thrombocytic purpura (TTP) during pregnancy: an algorithm and life-saving differential diagnosis

Thrombotic thrombocytopenic purpura (TTP) is a life-threatening thrombotic microangiopathic disorder characterized by severe thrombocytopenia, microangiopathic hemolysis, and multiorgan dysfunction. In obstetric practice, TTP often mimics severe forms of preeclampsia and HELLP syndrome (hemolysis, elevated liver enzymes, thrombocytopenia), leading to diagnostic errors and delays in treatment. This article presents the case of a young primiparous patient who, at 38 weeks of gestation, developed clinical features consistent with HELLP syndrome and was diagnosed with ADAMTS13 deficiency. This allowed for the confirmation of the diagnosis of TTP and prompt modification of treatment.