SUCCESSFUL TREATMENT OF THROMBOTIC THROMBOCYTOPENIC PURPURA WITH PLASMAPHERESIS AND RITUXIMAB-A CASE SERIES

Thrombotic thrombocytopenic purpura is a haematological disorder which affects the arterioles and capillaries of multiple organs.We report three cases of TTP successfully treated with plasmapheresis & low dosage rituximab.All three cases were diagnosed according to diagnostic criteria of TTP.A Weekly doses of 100 mg rituximab was given for four week(on day 1,day 8, day15 ,day22).Resolution of clinical symptoms and hemotological abnormalities after completion of treatment, all three patient achieved complete Response. The duration of complete response was 5-27 months. During the treatment course, All three patients were treated with plasmapheresis at different times, the recommended quantity of 9 plasmapheresis was 40 ml/kg once a day and the plasmapheresis was stopped when platelet dose went up to 150x10 . This case series indicates that plasmapheresis may positively support early salvage therapy in both acute/refractory and relapsing cases and its combination with rituximab exhibits short and long term favorable effects for the treatment of TTP.

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Long-term Efficacy of Rituximab Treatment in Thrombotic Thrombocytopenic Purpura

European Oncology & Haematology ◽

10.17925/eoh.2011.07.02.143 ◽

2011 ◽

Vol 07 (02) ◽

pp. 143

Author(s):

Jens M Chemnitz ◽

Michael Hallek ◽

Christof Scheid ◽

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...

Keyword(s):

Plasma Exchange ◽

Thrombotic Thrombocytopenic Purpura ◽

Case Reports ◽

Therapeutic Option ◽

Case Series ◽

Current Data ◽

Thrombocytopenic Purpura ◽

Long Term Follow Up

The use of therapeutic plasma exchange has reduced mortality rates in thrombotic thrombocytopenic purpura (TTP) from 90 to 1020%. However, TTP is a potentially lethal disorder, and management of patients with TTP refractory to plasma exchange or frequently recurrent disease is difficult. In those cases, rituximab might be a therapeutic option, although current data are based primarily on case reports and smaller case series. While initial response rates to rituximab are reported to be high, long-term follow-up data of patients treated with rituximab are rare; however, it is important to estimate the safety and benefit of this treatment. In this article we focus on current experience with rituximab in the treatment of TTP, including recent results with long-term follow-up.

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Short- and long-term effects of rituximab for the treatment of thrombotic thrombocytopenic purpura: four case reports

International Journal of Hematology ◽

10.1007/s12185-012-1162-2 ◽

2012 ◽

Vol 96 (4) ◽

pp. 506-512 ◽

Cited By ~ 10

Author(s):

Futoshi Iioka ◽

Daiki Shimomura ◽

Toru Ishii ◽

Yoshitomo Maesako ◽

Kazuhiro Ohgoe ◽

...

Keyword(s):

Thrombotic Thrombocytopenic Purpura ◽

Case Reports ◽

Long Term Effects ◽

Thrombocytopenic Purpura ◽

Short And Long Term

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Immune thrombotic thrombocytopenic purpura in older patients: prognosis and long-term survival

Blood ◽

10.1182/blood.2019000748 ◽

2019 ◽

Vol 134 (24) ◽

pp. 2209-2217 ◽

Cited By ~ 11

Author(s):

Renaud Prevel ◽

Claire Roubaud-Baudron ◽

Samuel Gourlain ◽

Matthieu Jamme ◽

Karine Peres ◽

...

Keyword(s):

Older Adults ◽

Thrombotic Thrombocytopenic Purpura ◽

Older Patients ◽

Delayed Diagnosis ◽

Term Survival ◽

Thrombocytopenic Purpura ◽

History Of ◽

Short And Long Term ◽

Long Term Mortality

Prevel and colleagues examined the natural history of thrombotic thrombocytopenic purpura (TTP) in older adults, reporting that the geriatric TTP population experiences delayed diagnosis and more severe neurologic and renal impairment. Older patients also have greater short- and long-term mortality.

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Thrombotic thrombocytopenic purpura: diagnostic criteria, clinical features, and long-term outcomes from 1995 through 2015

Blood Advances ◽

10.1182/bloodadvances.2017005124 ◽

2017 ◽

Vol 1 (10) ◽

pp. 590-600 ◽

Cited By ~ 64

Author(s):

Evaren E. Page ◽

Johanna A. Kremer Hovinga ◽

Deirdra R. Terrell ◽

Sara K. Vesely ◽

James N. George

Keyword(s):

Thrombotic Thrombocytopenic Purpura ◽

Diagnostic Criteria ◽

Kidney Function ◽

Clinical Judgment ◽

Adamts13 Activity ◽

Long Term Outcomes ◽

Thrombocytopenic Purpura ◽

Key Points ◽

Seriously Ill

Key Points The diagnosis of TTP requires clinical judgment in addition to measurement of ADAMTS13 activity. Patients with TTP may not seem to be seriously ill; they may have no or only mild neurologic and kidney function abnormalities.

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Mechanical failure of the Mobi-C implant for artificial cervical disc replacement: report of 4 cases

Journal of Neurosurgery Spine ◽

10.3171/2020.5.spine19442 ◽

2020 ◽

Vol 33 (6) ◽

pp. 727-733

Author(s):

Jasmine A. T. DiCesare ◽

Alexander M. Tucker ◽

Irene Say ◽

Kunal Patel ◽

Todd H. Lanman ◽

...

Keyword(s):

Cervical Spondylosis ◽

Case Series ◽

Dynamic Imaging ◽

Disc Replacement ◽

Cervical Disc ◽

Artificial Disc ◽

Younger Patients ◽

Cervical Disc Replacement ◽

Short And Long Term

Cervical spondylosis is one of the most commonly treated conditions in neurosurgery. Increasingly, cervical disc replacement (CDR) has become an alternative to traditional arthrodesis, particularly when treating younger patients. Thus, surgeons continue to gain a greater understanding of short- and long-term complications of arthroplasty. Here, the authors present a series of 4 patients initially treated with Mobi-C artificial disc implants who developed postoperative neck pain. Dynamic imaging revealed segmental kyphosis at the level of the implant. All implants were locked in the flexion position, and all patients required reoperation. This is the first reported case series of symptomatic segmental kyphosis after CDR.

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