Successful Treatment of Refractory Thrombotic Thrombocytopenic Purpura (TTP) With Caplacizumab: A Case Report

We report a female patient who presented with generalized weakness, episodes of altered mental status and slurred speech, and a history of systemic lupus erythematosus. Initial investigations showed profound thrombocytopenia and schistocytosis on peripheral blood smear. PLASMIC score was promptly ca...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2023-07, Vol.15 (7)
Main Authors: Pramanik, Debolina, Bhardwaj, Divyashish, Karmani, Vikash K, Raval, Girindra G, Kutlar, Abdullah
Format: Article
Language:English
Subjects:
Anemia
Antibodies
Apheresis
Blood platelets
Blood tests
Cancer
Case reports
Creatinine
Hematology
Hemoglobin
Hypertension
Immunosuppressive agents
Immunotherapy
Internal Medicine
Liver
Monoclonal antibodies
Mortality
Purpura
Thrombocytopenia
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Summary:We report a female patient who presented with generalized weakness, episodes of altered mental status and slurred speech, and a history of systemic lupus erythematosus. Initial investigations showed profound thrombocytopenia and schistocytosis on peripheral blood smear. PLASMIC score was promptly calculated, and plasma exchange with steroids was initiated based on the initial high PLASMIC score. Bone marrow examination showed hypocellular marrow without any other obvious abnormalities. The patient’s platelet counts initially improved but had a quick decline, on which, rituximab and subsequently caplacizumab were introduced. The patient was discharged after stabilization with plasma exchange (PLEX) therapy as needed on an outpatient basis.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.42423