Thrombotic thrombocytopenic purpura medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
TTP is a medical emergency and requires prompt treatment. | TTP is a medical emergency and requires prompt treatment. The mainstay of treatment for TTP is plasma exchange therapy. Surgery is recommended among all patients who develop TTP with no responsr to medical therapy. | ||
The mainstay of treatment for TTP is plasma exchange therapy. | |||
Surgery is recommended among all patients who develop TTP with no responsr to medical therapy. | |||
==Medical Therapy== | ==Medical Therapy== | ||
Revision as of 21:18, 25 September 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [2]
Overview
TTP is a medical emergency and requires prompt treatment. The mainstay of treatment for TTP is plasma exchange therapy. Surgery is recommended among all patients who develop TTP with no responsr to medical therapy.
Medical Therapy
- Patients with TTP are treated with daily plasma therapy.[1]
- Patients with TTP are treated with rituximab to prevent complications.[1]
- vincristine (VCR) is a agent to treat TTP patients resistant to conventional plasma exchange (PEX) and pharmacologic therapy.[2]
- cyclosporine A [3]
TTP treatment:
- Fresh frozen plasma(FFP) for patients who have inherited TTP
- Plasma exchange(PEX) for patients who have acquired TTP
- 1 Plasma therapy
- (1.53 plasma volume exchange for the first procedures, followed by 1.03 patient plasma volume thereafter)
- (1.53 plasma volume exchange for the first procedures, followed by 1.03 patient plasma volume thereafter)
- 2 Steroids
- Treatment of acquired TTP is high-dose methylprednisolone
- Methylprednisolone (10 mg/kg/day for 3 days and then 2.5 mg/kg/day), this dose is more efficacious than standard dose (1 mg/kg/day)
- Treatment of acquired TTP is high-dose methylprednisolone
- 3Rituximab[4]
- Standard treatment(375 mg/m2 in 4 weekly doses)
- 1 Plasma therapy
References
- ↑ 1.0 1.1 Joly, Bérangère S.; Coppo, Paul; Veyradier, Agnès (2017). "Thrombotic thrombocytopenic purpura". Blood. 129 (21): 2836–2846. doi:10.1182/blood-2016-10-709857. ISSN 0006-4971.
- ↑ Bobbio-Pallavicini E, Porta C, Centurioni R, Gugliotta L, Vianelli N, Tacconi F, Billio A, Ascari E (April 1994). "Vincristine sulfate for the treatment of thrombotic thrombocytopenic purpura refractory to plasma-exchange. The Italian Cooperative Group for TTP". Eur. J. Haematol. 52 (4): 222–6. PMID 8005232.
- ↑ Medina PJ, Sipols JM, George JN (September 2001). "Drug-associated thrombotic thrombocytopenic purpura-hemolytic uremic syndrome". Curr. Opin. Hematol. 8 (5): 286–93. PMID 11604563.
- ↑ Scully M, Hunt BJ, Benjamin S, Liesner R, Rose P, Peyvandi F, Cheung B, Machin SJ (August 2012). "Guidelines on the diagnosis and management of thrombotic thrombocytopenic purpura and other thrombotic microangiopathies". Br. J. Haematol. 158 (3): 323–35. doi:10.1111/j.1365-2141.2012.09167.x. PMID 22624596.