• Pasquale Agosti, Ilaria Mancini, Francesca Gianniello, Paolo Bucciarelli, Andrea Artoni, Barbara Ferrari, Silvia Pontiggia, Silvia Maria Trisolini, Luca Facchini, Cecilia Carbone, Flora Peyvandi, and Italian Group of TTP Investigators.
• Department of Pathophysiology and Transplantation, Università degli Studi di Milano,Via Pace 9, Milan, 20122, Italy.
• Eur. J. Intern. Med. 2020 May 1; 75: 79-83.

BackgroundThe prevalence of older patients with acquired thrombotic thrombocytopenic purpura (TTP) is increasing. There is scarce information on the prevalence of multimorbidity, polypharmacy and age-related diseases in aging TTP patients. This study aimed to evaluate the prevalence of multimorbidity and polypharmacy in a population of acquired TTP patients aged 65 years or more compared with a group of age-matched controls.MethodsAcquired TTP patients enrolled in the Milan TTP registry from December 1st 1999 to March 31th 2018 and aged 65 years or more at the date of last follow-up were evaluated. Controls were Italian healthy individuals recruited from 2006 to March 31th 2018 among friends and non-consanguineous relatives of patients tested for thrombophilia screening at the Angelo Bianchi Bonomi Hemophilia and Thrombosis Center of Milan.Results36 TTP patients and 127 age-matched controls were included. Compared with controls, TTP patients had a higher prevalence of multimorbidity and polypharmacy. They also showed a higher prevalence of autoimmune diseases, osteoporosis and arterial hypertension and were more chronically treated with corticosteroids and antiplatelets for primary cardiovascular prevention. All these results were confirmed after adjusting for sex. Compared with the general elderly population, TTP patients showed a higher prevalence of ischemic heart disease and stroke.ConclusionsOur findings suggest that a careful comprehensive geriatric assessment of acquired TTP patients is necessary. It is important to look for other autoimmune diseases and such age-related comorbidities as osteoporosis, arterial hypertension, ischemic heart disease and cerebrovascular disease.Copyright © 2020. Published by Elsevier B.V.

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