title: Response to rituximab in a refractory case of thrombotic thrombocytopenic purpura associated with systemic lupus erythematosus.
abstract: Thrombotic thrombocytopenic purpura (TTP) is a serious disorder with a significant morbidity and mortality. Majority of cases of TTP are idiopathic, but some cases may be secondary to connective tissue diseases. TTP has been rarely associated with systemic lupus erythematosus (SLE) and may be refractory to treatment with plasma exchange, requiring immunosuppressive therapy. We describe a patient with TTP and SLE who was refractory to plasma exchange and corticosteroids but responded to anti-CD20 antibody rituximab with continued remission after eight months of follow-up. Rituximab appears to be an effective treatment in refractory cases of TTP associated with SLE.
authors.affiliation: Department of Medicine, Division of Nephrology and Division of Hematology/Oncology, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh 11472, Saudi Arabia. faniaz02@yahoo.com
authors.forename: Faraz Azim
authors.initials: FA
authors.lastname: Niaz
authors.forename: Aamer
authors.initials: A
authors.lastname: Aleem
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000628:therapy; D010951:Plasma Exchange; D011697:Purpura, Thrombotic Thrombocytopenic / Q000188:drug therapy* / Q000209:etiology; D000069283:Rituximab; D013997:Time Factors; D017211:Treatment Failure
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007166:Immunosuppressive Agents; D000069283:Rituximab