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[Differential therapy of thrombotic-thrombopenic purpura. Administration of fresh plasma versus plasma separation].

Abstract
In a 29-year-old man with primary thrombotic-thrombocytopenic purpura a significantly increased plasma concentration of platelet-specific proteins was demonstrated as an expression of increased intravascular platelet activation and destruction during the acute phase of the disease. There was also abnormally elevated IgG loading of platelets. During administration of fresh plasma alone (total of six litres over one week) the clinical state deteriorated further into coma and failure of spontaneous ventilation. The marked thrombocytopenia and microangiopathic haemolytic anaemia remained unchanged. Only after repeated plasmapheresis was it possible to break through the acute disease process. Remission (restoration of vital functions, normalization of platelet count and haemolysis signs) was achieved after five courses of plasmapheresis with a total exchange volume of 20 litres. At least in this case, the therapeutic success of plasmapheresis argues for an immunological-toxic genesis of thrombotic-thrombocytopenic purpura.
AuthorsC Aul, R E Scharf, T Königshausen, H Küppers, B Grabensee
JournalDeutsche medizinische Wochenschrift (1946) (Dtsch Med Wochenschr) Vol. 109 Issue 50 Pg. 1922-6 (Dec 14 1984) ISSN: 0012-0472 [Print] Germany
Vernacular TitleDifferentialtherapie der thrombotisch-thrombozytopenischen Purpura. Frischplasmagabe versus Plasmaseparation.
PMID6542489 (Publication Type: Case Reports, English Abstract, Journal Article)
Chemical References
  • Immunoglobulin G
  • Dipyridamole
  • Heparin
  • Aspirin
  • Methylprednisolone
Topics
  • Acute Kidney Injury (therapy)
  • Adult
  • Aspirin (therapeutic use)
  • Blood Platelets (immunology)
  • Blood Transfusion
  • Dipyridamole (therapeutic use)
  • Erythrocytes
  • Heparin (therapeutic use)
  • Humans
  • Immunoglobulin G (immunology)
  • Male
  • Methylprednisolone (therapeutic use)
  • Plasma
  • Plasma Exchange
  • Plasmapheresis
  • Platelet Count
  • Proteinuria (diagnosis)
  • Purpura, Thrombotic Thrombocytopenic (therapy)
  • Renal Dialysis
  • Syncope (therapy)
  • Urine (cytology)

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