MICROVASCULAR DAMAGE IN THROMBOTIC THROMBOCYTOPENIC PURPURA

STUDY OF MICROVASCULAR DAMAGE IN PATIENTS WITH THROMBOTIC THROMBOCYTOPENIC PURPURA

The goal of this interventional, non-pharmacological clinical study is to assess microcirculatory dysfunction in patients with thrombotic thrombocytopenic purpura (TTP), both during the acute phase and in remission, compared with the general population.

Microcirculatory damage will be defined as the presence of at least one abnormal instrumental finding among brain magnetic resonance imaging (MRI), optical coherence tomography angiography (OCT-A), and nailfold videocapillaroscopy.

This is a monocentric, national study including two patient cohorts:

Cohort 1: patients enrolled during the acute phase Cohort 2: patients enrolled during remission Participants will be followed for three years with a total of five study visits.

Researchers will not test any drug but will perform detailed clinical, laboratory, and instrumental assessments to evaluate microvascular involvement over time.

Participants will:

• Undergo clinical evaluation, including internal medicine and neurological assessments
• Provide blood and urine samples for laboratory analyses
• Undergo instrumental examinations such as brain MRI, OCT-A, and nailfold videocapillaroscopy
• Receive psychological/neuropsychological evaluations
• Attend follow-up visits over a 3-year period (at baseline, 3 months [cohort 1 only], 12, 24, and 36 months)

Inclusion Criteria:

• aged ≥18 years
• diagnosis of TTP (either congenital or acquired immune-mediated TTP)
• referred at our hospital (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, S.C. Medicina - Emostasi e Trombosi)
• providing a signed informed consent

Exclusion Criteria:

• Patients who do not possess the above inclusion criteria
• Patients who have known contraindications to the instrumental exam included in the study.