Case Report

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

Authors: Aneley Hundae, MD, Stanley Peskoe, MD, Edwin Grimsley, MD, Shomeet Patel, MD

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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