Thrombotic thrombocytopenic purpura. Remission following hemodialysis

The Pathogenesis of Thrombotic Thrombocytopenic Purpura

“…On the other hand, the use of exchange transfusion may produce additional benefits by the removal of the damaged red cells and other hypothetical platelet aggregating factors. This is supported by reports that the response can also occur following hemodialysis [80]. * In either case, these therapeutic modalities represent a significant advance in the management of this grave illness.…”

“…The severity of hemolysis and the damage inflicted on the red cells can be seen in cross-transfusion experiments. A markedly shortened erythrocyte life-span of only 3-6 days was found when normal red cells were transfused to TTP patients [56,80]. Also, the patients' circulating red cells, damaged to a significant degree, had a shortened life span when given to a normal recipient [80].…”

Demonstration of Immune Complexes in Thrombotic Thrombocytopenic Purpura and Effect of Exchange Transfusion

“…Several recently introduced modalities of treatment appear to have improved the poor prognosis associated with TTP. Remissions have been reported with large dose corticosteroids and splenectomy (Cuttner 1974), haemodialysis (Tartaglia & Burkhardt 1971), and platelet inhibiting drugs (Eckel et a1 1977). The most dramatic improvements have however been noted with exchange transfusion and plasmapheresis (Bukowski et a1 1976, Pisciotta et a1 1977.…”

Thrombotic thrombocytopenic purpura: Recovery after plasmapheresis, corticosteroids, splenectomy, and antiplatelet agents

“…Whole blood exchange transfusion was successfully employed by Rubinstein et a1 in a case of TTP [31] as early as 1959. Hemodialysis has also been employed, especially in patients with renal insufficiency [32,33]. Remissions after transfusions of plasma were reported by Byrnes and Khurana [34], as well as by Deuel and Gardner [6].…”