A 25 years old girl is brought to the emergency department in the state of altered sensorium with high grade fever. Investigation revealed anemia, thrombocytopenia with fragmented red cells on peripheral blood smear examination. CTbrain is normal and a serum creatinine is 3.0 mg/dl. PT/APTT/TT are normal. Which of the following is the most effective treatment?
Plasma exchange therapy
Steriods with IVIg
Broad–spectrum IV antibiotics
Answer. A. Plasma exchange therapy
The mainstay of therapy for TTP is plasma exchange with the exception of factor H deficiency and possibly APS syndrome and quinine–induced disease.
No compelling evidence indicates that plasma therapy is effective for thrombotic micro-angiopathy caused by a mechanism other than ADAMTS 13 deficiency.