Rituximab for Thrombotic Thrombocytopenic Purpura: A Case Report
Abstract
Thrombotic thrombocytopenic purpura (TTP) is a rare thrombotic microangiopathy (TMA). The diagnosis is difficult and can be easily missed. TTP is an emergency condition, and its treatment must not be delayed once a diagnosis is established. Delays in treatment may result in significant morbidity and mortality. There has been a significant reduction in the mortality rate following the emergence of plasma exchange therapy. However, a high rate of recurrence has been noted in those who have achieved remission. Patients who fail to respond to plasma exchange therapy may respond to various other drugs. One such drug is rituximab, which is an anti-CD20 antibody that depletes B cells.
We present a case of a 38-year-old man with anaemia, thrombocytopenia, elevated creatinine, increased lactate dehydrogenase (LDH), seizures, and schistocytes in the peripheral smear, which favoured TTP. The absence of a disintegrin and metalloproteinase with thrombospondin motifs 13 (ADAMTS13) levels confirmed TTP. The patient responded to rituximab therapy and was cured of TTP.
TTP is a relatively uncommon condition with the potential to develop serious consequences leading to mortality. Early diagnosis and treatment are essential to avoid this. In our case, due to the early diagnosis and therapy, the patient was cured of the dreadful disease.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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