title: Combined plasma exchange and platelet transfusion in immune-mediated thrombocytopenic emergencies.
abstract: Refractory immune-mediated thrombocytopenia (ITP) can be very difficult to manage, especially if associated with a hemorrhagic or surgical emergency. We report two cases of refractory ITP that were unresponsive to routine therapeutic interventions and frequent platelet transfusions. A combination of plasma exchange and platelet transfusion successfully raised the platelet count to a level that permitted life-saving surgical interventions. Plasma exchange in these two cases likely reduced platelet antibodies significantly, decreasing platelet destruction. We propose that a trial of combination plasma exchange and platelet transfusion can be attempted in emergent thrombocytopenic situations with an underlying immune mechanism.
authors.affiliation: Mayo Clinic, Jacksonville, FL, United States. Electronic address: finn.laura@mayo.edu.
authors.forename: Laura
authors.initials: L
authors.lastname: Finn
authors.forename: Han
authors.initials: H
authors.lastname: Tun
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange / Q000295:instrumentation / Q000379:methods*; D017713:Platelet Transfusion / Q000295:instrumentation / Q000379:methods*; D013921:Thrombocytopenia / Q000276:immunology* / Q000628:therapy*
keywords: Immune mediated thrombocytopenia; Plasma exchange