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Thrombotic thrombocytopenic purpura: Prolonged coma with recovery of neurologic function with intensive plasma exchange
Author(s) -
Frankel Arthur E.,
Rubenstein Martin D.,
Wall Robert T.
Publication year - 1981
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830100408
Subject(s) - thrombotic thrombocytopenic purpura , discontinuation , coma (optics) , medicine , microangiopathic hemolytic anemia , vincristine , schistocyte , exchange transfusion , therapeutic plasma exchange , purpura (gastropod) , plasmapheresis , pediatrics , gastroenterology , platelet , immunology , chemotherapy , cyclophosphamide , ecology , physics , antibody , optics , biology
A 45‐year‐old‐woman was presented with fever, microangiopathic hemolytic anemia, thrombocytopenia, purpura, and mental status changes. She was diagnosed as having thrombotic thrombocytopenic purpura (TPP). She was treated with daily plasma exchange and antiplatelet drugs, steroids, and vincristine. This patient had a remarkable course with 18 days of coma on full therapy followed by essentially complete recovery coincident with an increase of the plasma exchange dose to two plasma volumes processed per procedure. The patient has remained well with discontinuation of plasma exchange. We conclude that prolonged coma without evidence of major central nervous system structural lesions in TTP should be treated vigorously and continuously with plasma exchange.