Thrombotic thrombocytopenic purpura with a complicated clinical course successfully treated with rituximab: A case report
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Abstract
Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening thrombotic microangiopathy. Although modern therapeutic strategies have significantly improved patient outcomes, managing cases with a complicated clinical course remains a challenge in clinical practice. We report the case of a 64-year-old previously healthy male who presented with fever and diarrhea. His clinical condition rapidly deteriorated, with focal neurological deficits, severe thrombocytopenia, and evidence of microangiopathic hemolytic anemia. Recurrent thrombocytopenia following an initial recovery to > 150 × 109/L after five sessions of therapeutic plasma exchange (TPE) reflected an unstable hematologic course and a suboptimal response to initial therapy; concurrently, severely reduced ADAMTS13 activity supported the diagnosis of TTP. The timely addition of rituximab, combined with intensified TPE, resulted in a marked improvement, with recovery of platelet counts and complete resolution of neurological manifestations. This case highlights the importance of early recognition of TTP and underscores the role of rituximab in cases with a complicated clinical course.
Article Details
Keywords
Thrombotic thrombocytopenic purpura, therapeutic plasma exchange, rituximab
References
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