Foot Manifestations of the Thrombotic Thrombocytopenic Purpura Hemolytic-Uremic Syndrome: A Review and Case Report

The thrombotic thrombocytopenic-hemolytic uremic (TTP-HUS) syndrome is a thrombotic microangiopathy involving end-organ vascular beds. Microcirculatory thrombosis results in ischemic changes in any number of organ systems, especially the central nervous and renal systems. Musculoskeletal system involvement is less well described, but when it occurs, acral ischemia may be severe. TTP-HUS is well recognized as a complication of organ transplantation, drug therapy, in pregnancy, and as a chronic, relapsing congenital disorder. Bacterial sepsis may also result in a thrombotic microangiopathy of the central nervous and renal systems (TTP-HUS). This article presents a case report and discusses the pathogenesis and lower-extremity manifestations of TTP-HUS, and outlines management strategies.