title: Anti-CD20 antibody in thrombotic thrombocytopenic purpura refractory to plasma exchange.
abstract: Thrombotic thrombocytopenic purpura is a rare condition characterized by microangiopathic haemolytic anaemia, thrombocytopenia, altered neurology, renal impairment and fever. While plasma exchange has reduced mortality from more than 90% to between 10 and 30%, a proportion of cases fail to respond. Rituximab may be efficacious in the management of refractory cases of thrombotic thrombocytopenic purpura. We present two cases in which rituximab was used with successful outcomes. Treatment resulted in resolution of severe clinical and haematological abnormalities in both patients. There has been no relapse after 16 months follow up. Our experience supports the use of rituximab in difficult cases of TTP. Ongoing evaluation of its use is in progress at our institution.
authors.affiliation: Department of Nephrology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: K V
authors.initials: KV
authors.lastname: Chow
authors.forename: R
authors.initials: R
authors.lastname: Carroll
authors.forename: P
authors.initials: P
authors.lastname: Branley
authors.forename: K
authors.initials: K
authors.lastname: Nicholls
authors.forename: G
authors.initials: G
authors.lastname: Becker
authors.forename: C
authors.initials: C
authors.lastname: Hogan
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange; D011697:Purpura, Thrombotic Thrombocytopenic / Q000188:drug therapy* / Q000628:therapy; D000069283:Rituximab; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D007155:Immunologic Factors; D000069283:Rituximab