A CASE OF THROMBOTIC THROMBOCYTOPENIC PURPURA SUCCESSFULLY TREATED BY PLASMA EXCHANGE AND HIGH-DOSE METHYLPREDNISOLONE

• Published in: Journal of the Japan Society of Blood Transfusion Vol. 35; no. 1; pp. 56 - 60
• Main Authors: Masuya, Masahiro, Tamaki, Shigehisa, Kobayashi, Toru, Takagi, Mikio, Deguchi, Katsumi, Sekine, Takao, Minami, Nobuyuki, Wada, Hideo, Shirakawa, Shigeru
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society of Transfusion Medicine and Cell Therapy 1989
• ISSN: 0546-1448; 1883-8383; 1883-8383
• DOI: 10.3925/jjtc1958.35.56

A 61-year-old male was hospitalized because of bleeding tendency and impaired consciousness. Based on the findings of thrombocytopenia, microangiopathic hemolytic anemia, unstable neurological symptom, fever and renal insufficiency, he was diagnosed as having thrombotic thrombocytopenic purpura (TTP). He was treated immediately by plasma exchange (4000ml×4 times), and responded dramatically well. His thrombocytopenia and neurological symptom were improved. However, on the 8th hospital day, thrombocytopenia was recurrently noted and he was made a diagnosis of having a relapse. So he was successively treated by high-dose methylprednisolone and achieved complete remission, which has continued for 16 months. We speculate that autoimmune factors caused vessel-endothelial disturbance, which trigger the development of TTP. Here we also describe three other cases of TTP successfully treated by plasma exchange.