title: Twice daily plasma exchange in refractory thrombotic thrombocytopenic purpura.
abstract: Thrombotic thrombocytopenic purpura (TTP) usually responds to daily single total plasma exchange (TPE) or to plasma infusion. However, some cases are refractory to total plasma exchange, and additional efficacious treatment may not be available. A 34-year-old white male diagnosed with TTP was found to be refractory to single TPE. Steroids and twice daily TPE, in addition to splenectomy and vincristine, worked well to prevent further clinical deterioration. Laboratory values were normalized at the completion of treatment protocol. Cases of TTP refractory to single TPE/day may benefit from early treatment of twice-daily TPE in addition to a combination therapy of steroids, splenectomy, and vincristine.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Louisville, Louisville KY 40292, USA. ekahwash@yahoo.com
authors.forename: Eiad
authors.initials: E
authors.lastname: Kahwash
authors.forename: William B
authors.initials: WB
authors.lastname: Lockwood
mesh_terms: D000328:Adult; D001663:Bilirubin / Q000097:blood; D001792:Blood Platelets / Q000378:metabolism; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D006400:Hematocrit; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D010951:Plasma Exchange / Q000379:methods*; D011697:Purpura, Thrombotic Thrombocytopenic / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D003404:Creatinine; D007770:L-Lactate Dehydrogenase; D001663:Bilirubin