Successful treatment of plasma exchange-refractory thrombotic thrombocytopenic purpura with rituximab: A case report
| Autor: | Jingxia Jin, Jian Huang, Xiaofei Xu, Xuan-Xuan Zhang, Xingnong Ye, Jian Chen |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
business.industry Thrombotic thrombocytopenic purpura General Medicine medicine.disease ADAMTS13 Gastroenterology 03 medical and health sciences 0302 clinical medicine Refractory immune system diseases hemic and lymphatic diseases 030220 oncology & carcinogenesis Internal medicine Case report medicine Plasma exchange 030211 gastroenterology & hepatology Rituximab business medicine.drug |
| Zdroj: | World Journal of Clinical Cases |
| ISSN: | 2307-8960 |
| DOI: | 10.12998/wjcc.v8.i12.2617 |
| Popis: | BACKGROUND Thrombotic thrombocytopenic purpura (TTP), a subtype of thrombotic microangiopathy, has a very high fatality rate if there is no timely diagnosis or treatment. Here, we report a case of TTP refractory to high displacement plasma exchange, which was later successfully treated with rituximab. CASE SUMMARY Here we report a case of refractory TTP in a 63-year-old woman with a low platelet count and decreased ADAMTS13 activity. Her platelet count was 9 × 109/L, hemoglobin level was 81 g/L, and ADAMTS13 was < 5%. She was diagnosed with thrombotic thrombocytopenic purpura. After 8 d of daily plasma exchange (PEX), her platelet levels were still low. However, after 6 d of treatment with rituximab, her platelet count increased and ADAMTS13 activity returned to normal. CONCLUSION PEX can cure most patients, but the relapse rate can be up to 50%-60%. This case suggested that rituximab can improve the curative efficiency of PEX and prevent disease relapse in TTP. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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