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Pegylated bovine carboxyhaemoglobin utilisation in a thrombotic thrombocytopenic purpura patient
Author(s) -
Sam C.,
Desai P.,
Laber D.,
Patel A.,
Visweshwar N.,
Jaglal M.
Publication year - 2017
Publication title -
transfusion medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 59
eISSN - 1365-3148
pISSN - 0958-7578
DOI - 10.1111/tme.12407
Subject(s) - medicine , thrombotic thrombocytopenic purpura , thrombotic microangiopathy , apheresis , surgery , platelet , disease
SUMMARY Objective To determine if pegylated bovine carboxyhaemoglobin can be utilised in a thrombotic thrombocytopenic purpura ( TTP ) patient. Background TTP is a condition characterized by thrombotic microangiopathy and has a high mortality rate when left untreated. Therapeutic plasma exchange is well established as the most effective and evidence‐based treatment of TTP . Methods The ability to administer plasma exchange therapy is limited in Jehovah's Witnesses who decline blood products due to religious beliefs. Pegylated bovine carboxyhaemoglobin is a novel oxygen transfer agent in development for the management of complications of ischaemia due to acute anaemia. Results Treatment was well tolerated, with grade 1 paresthesia of the right face and arm 1 h after the first infusion of Sanguinate, which spontaneously resolved and did not recur, and grade 1 cardiac troponin elevation after receiving the medication (with peak at 0·079 ng mL −1 ), but further workup with electrocardiogram and echocardiogram was unremarkable. By discharge on day 19, the patient's haemoglobin increased to 8·8 g dL −1 and platelet count to 221 000. Conclusions We report the first case of TTP in a Jehovah's Witness that was successfully managed with the use of pegylated bovine carboxyhaemoglobin as an adjunct medication.