Plasma Exchange and Concomitant Therapy in TTP
| Autor: | P. Unterburger, Stoffner D, Habersetzer R, Walter Samtleben, F.C.A. Banthien, Hans J. Gurland, J. Zähringer, C. Clemm |
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| Rok vydání: | 1984 |
| Předmět: |
medicine.medical_specialty
Vincristine Disease entity business.industry medicine.medical_treatment Splenectomy 030232 urology & nephrology Biomedical Engineering Thrombotic thrombocytopenic purpura Medicine (miscellaneous) Bioengineering General Medicine 030204 cardiovascular system & hematology medicine.disease Biomaterials 03 medical and health sciences 0302 clinical medicine Apheresis Internal medicine Concomitant Therapy Medicine Plasmapheresis Fresh frozen plasma business medicine.drug |
| Zdroj: | The International Journal of Artificial Organs. 7:223-228 |
| ISSN: | 1724-6040 0391-3988 |
| DOI: | 10.1177/039139888400700413 |
| Popis: | Since plasma exchange was introduced in the management of thrombotic thrombocytopenic purpura (TTP) in 1977, patient survival rate has increased from 10 to 80%. However, ∼50 subsequent case reports in the literature provide no consensus as to the optimal therapy. We review here 4 episodes of TTP in 3 patients. In all cases, treatment was started with intensive FFP plasma exchange combined with administration of antiplatelet agents and corticosteroids. Remission was achieved in 3 out of 4 episodes although all required individualization of the medication regimen. In the remaining patient, cytotoxic therapy (vincristine) and ultimately splenectomy were required to achieve stable remission. The variable clinical response to these therapeutic protocols indicates that TTP may not represent a single homogeneous disease entity but rather may involve various underlying pathologies. We conclude that the most effective present therapy for the management of TTP is daily plasma exchange with fresh frozen plasma infusions combined with antiplatelet agents and steroids. Vincristine and splenectomy should only be employed if this protocol proves ineffective. |
| Databáze: | OpenAIRE |
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