Response of Refractory Thrombotic Thrombocytopenic Purpura to Extracorporeal Immunoadsorption

To the Editor: Thrombotic thrombocytopenic purpura (TTP) is a relatively rare disorder of unknown cause that is characterized by microangiopathic hemolytic anemia, thrombocytopenia with normal plasma coagulation, transient and fluctuating neurologic symptoms, fever, and varying degrees of renal dysfunction. 1 Improvement is achieved most frequently with a combination of glucocorticoids, platelet inhibitors, and therapeutic plasma exchange. TTP may be induced by chemotherapy, in which case it is apt to be refractory to standard therapy but responsive to protein A immunoadsorption. 1 , 2 This observation prompted us to use immunoadsorption in the case of a patient with classic TTP that became refractory to therapeutic . . .