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Rituximab Therapy for Refractory Thrombotic Thrombocytopenic Purpura and Autoimmune-Mediated Thrombocytopenia in Systemic Lupus Erythematosus

Aneley Hundae, MD, Stanley Peskoe, MD, Edwin Grimsley, MD, Shomeet Patel, MD
Volume: 101 Issue: 9 September, 2008

Abstract:

Thrombotic thrombocytopenic purpura (TTP) rarely occurs in the setting of systemic lupus erythematosus (SLE); when it does occur it has a high mortality rate and is refractory to conventional treatment. No clear treatment guidelines exist when refractory TTP occurs in the setting of SLE. A 24-year-old male patient presented with TTP in the setting of SLE that was refractory to conventional treatment but responded to rituximab.


Key Points


* Thrombotic thrombocytopenic purpura (TTP) should be considered in the differential diagnosis of thrombocytopenia in systemic lupus erythematosus (SLE).


* When TTP occurs in the setting of SLE, it is usually difficult to treat.


* Rituximab should be considered in refractory cases of TTP.


* Rituximab should also be considered in immune-mediated refractory thrombocytopenia associated with SLE.

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References:

1. Reff ME, Carner K, Chambers KS, et al. Depletion of B cells in vivo by a chimeric mouse human monoclonal antibody to CD20. Blood 1994;83:435–445.
 
2. Moschowitz E. Hyaline thrombosis of terminal arterioles and capillaries: a hitherto under scribed disease. Proc NY Pathol Soc 1924;24:21–24.
 
3. Porta C, Caporali R, Montecucco C. Thrombotic thrombocytopenic purpura and autoimmunity: a tale of shadows and suspects. Haematologica 1999;84:260–269.
 
4. Tsai HM, Lain EC. Antibodies to von Willebrand cleaving protease in acute thrombotic thrombocytopenic purpura. N Eng J Med 1998;339:1585–1594.
 
5. Furlan M, Scharrer I, Aumann V, et al. Von Willebrand factor cleaving protease in thrombotic thrombocytopenic purpura and the hemolytic uremic syndrome. N Engl J Med 1998;339:1578–1584.
 
6. Reddy PS, Deauna-limayo D, Cook JD, et al. Rituximab in the treatment of relapsed thrombotic thrombocytopenic purpura. Ann Hematol 2005;84:232–235.
 
7. Chemnitz J, Draube A, Scheid C, et al. Successful treatment of severe thrombotic thrombocytopenic purpura with monoclonal antibody rituximab. Am J Hematol 2002;71:105–108.

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