Prevel R, Roubaud-Roubaud C, Gourlain S, et al. - Researchers examined clinical characteristics and long-term influence of Immune Thrombotic Thrombocytopenic Purpura (iTTP) on death in older patients (> 60 yo). Participants were adult iTTP patients with acquired severe ADAMTS-13 deficiency (< 10%) who were registered in the registry of the French Reference Center for Thrombotic Microangiopathies between 2000 and 2016. These individuals were studied for their features and prognosis according to age (< 60 yo or ≥ 60 yo). Longer time from hospital admission to diagnosis was reported when older iTTP patients (N = 71) were compared with younger patients (N = 340); at diagnosis, delirium, behavior impairment, renal involvement and high troponin level were more significant whereas cytopenias were less profound. Factors that showed an independent link with 1-month mortality were age ≥ 60, cardiac involvement, increased plasma creatinine level and total plasma exchange volume. Increased long-term mortality was observed in older survivors vs a non-iTTP geriatric population. A frequent atypical neurological presentation was noted in older iTTP patients, possibly resulting in a delay to diagnosis. A negative influence of age on 1-month and 1-year mortality was also evident.