title: Acquired idiopathic thrombotic thrombocytopenic purpura successfully treated with intravenous immunoglobulin and glucocorticoid: A case report.
abstract: BACKGROUND
  Plasma exchange is the principal treatment for acquired thrombotic thrombocytopenic purpura (TTP) but is invasive and may have adverse effects. Reports of immunoglobulin therapy for acquired TTP without plasma exchange are rare.
  
  
  METHODS
  A 14-year-old girl was admitted because of hemolytic anemia and thrombocytopenia.
  
  
  METHODS
  Acquired TTP was diagnosed based on low ADAMTS13 (a disintegrin-like and metalloproteinase with thrombospondin type 1 motif, 13) activity and a high ADAMTS13 inhibitor level.
  
  
  RESULTS
  Fresh frozen plasma was initially effective. Prednisolone and immunoglobulin resolved the condition with no adverse effects and rendered plasma exchange unnecessary.
  
  
  CONCLUSIONS
  Compared with biological agents, immunoglobulin is cost-effective, readily available, and has a proven long-term safety record, making it a possible treatment option for acquired thrombotic thrombocytopenic purpura.
authors.affiliation: Department of General Pediatrics Department of Postgraduate Education and Training Division of Hematology, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo Department of Blood Transfusion Medicine, Nara Medical University, Shijo-cho, Kashihara, Nara, Japan.
authors.forename: Hiro
authors.initials: H
authors.lastname: Nakao
authors.forename: Akira
authors.initials: A
authors.lastname: Ishiguro
authors.forename: Nahoko
authors.initials: N
authors.lastname: Ikoma
authors.forename: Kentaro
authors.initials: K
authors.lastname: Nishi
authors.forename: Chemin
authors.initials: C
authors.lastname: Su
authors.forename: Hisaya
authors.initials: H
authors.lastname: Nakadate
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Kubota
authors.forename: Masaki
authors.initials: M
authors.lastname: Hayakawa
authors.forename: Masanori
authors.initials: M
authors.lastname: Matsumoto
mesh_terms: D000293:Adolescent; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D011239:Prednisolone / Q000627:therapeutic use*; D011697:Purpura, Thrombotic Thrombocytopenic / Q000188:drug therapy*
chemical_list: D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D011239:Prednisolone