# Acquired Thrombotic Thrombocytopenic Purpura (TTP) Presenting With Synthetic Cannabinoid Use

## TL;DR

A woman's use of synthetic cannabinoids led to a rare blood disorder called TTP, highlighting the importance of detailed patient history and timely diagnosis.

## Contribution

This case report highlights the diagnostic challenges of TTP when combined with synthetic cannabinoid use.

## Key findings

- Synthetic cannabinoids can cause altered mental status, complicating TTP diagnosis.
- Detailed social history and prompt recognition of lab abnormalities are crucial for timely TTP diagnosis.
- TTP diagnosis delays can lead to significant health risks.

## Abstract

Synthetic cannabinoids (SCs) have become commercially available throughout the United States as manufacturers circumvent regulations with labels stating “not for human consumption” with misleading advertisements, resulting in the consumption of products that are not safe or regulated. We present a case report of a middle-aged woman exhibiting altered mental status secondary to SC use who was found to have severe thrombocytopenia and hemolytic anemia. She was later confirmed to have thrombotic thrombocytopenic purpura (TTP) through ADAMTS13 testing. TTP is one of several platelet-related disorders presenting with findings of hemolytic anemia and thrombocytopenia. The presence of altered mental status is typically used as a symptomatic differentiator between hemolytic uremic syndrome, immune thrombocytopenic purpura, and TTP. SCs can cause superimposed altered mental status, which, in the setting of a concomitant platelet disorder, can complicate the standard workup and prolong the time to a final diagnosis. This case serves as an essential reminder that collecting detailed social history and promptly recognizing laboratory abnormalities is critical for early recognition of TTP, as the diagnosis is time-sensitive and delays in recognition can lead to significant morbidity and mortality.