[Treatment of thrombotic thrombocytopenic purpura--retrospective analysis on Japanese patients and review. Japan TTP Research Group].
Thrombotic thrombocytopenic purpura (TTP), uncommon and still unclarified in pathogenesis, has been treated by various methods, including antiplatelet drugs, steroids, heparin and recently, plasma infusion, and plasma exchange. To evaluate the effectiveness of each therapy or its combination, we analyzed the data of 56 patients with TTP in Japan by a questionnaire. The mortality was 26.8%. Plasma exchange and infusion usually combined with other drugs (steroids, antiplatelet drugs etc.) seemed more effective than therapies without exchange or infusion. We employed a scoring method to express the severity of TTP, using platelet count, hemoglobin level and serum lactate dehydrogenase, creatinine and bilirubin levels as parameters. This scoring method showed objectively the effectiveness of antiplatelet drugs, steroids, or plasma exchange or infusion, and especially, the effectiveness of the latter two (singly or combined) in seven patients who did not respond to other therapies. In conclusion, plasma exchange and infusion are suggested for the treatment of TTP, especially, the severe type. Combination of antiplatelet drugs and/or steroids remains to be evaluated.
Hattori
A
A
Sado General Hospital.
Tatewaki
W
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D016913:Blood Component Transfusion; D002648:Child; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D011379:Prognosis; D011697:Purpura, Thrombotic Thrombocytopenic / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D013156:Splenectomy; D011795:Surveys and Questionnaires
D010975:Platelet Aggregation Inhibitors; D011239:Prednisolone