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How I treat patients with thrombotic thrombocytopenic purpura: 2010

Open access
George, James N.·2010·Blood

Abstract

Thrombotic thrombocytopenic purpura (TTP) is the common name for adults with microangiopathic hemolytic anemia, thrombocytopenia, with or without neurologic or renal abnormalities, and without another etiology; children without renal failure are also described as TTP. The diagnosis of TTP is an indication for plasma exchange treatment, but beginning treatment requires sufficient confidence in the diagnosis to justify the risk of plasma exchange complications. Documentation of a severe deficiency of plasma ADAMTS13 activity, defined as less than 10% of normal, is not essential for the diagnosis of TTP. Some patients without severe ADAMTS13 deficiency may benefit from plasma exchange treatment; in addition, some patients with severe ADAMTS13 deficiency may subsequently be diagnosed with another cause for their clinical features. However, severe acquired ADAMTS13 deficiency does define a subgroup of patients who appear to benefit from treatment with corticosteroids and other immunosuppressive agents in addition to plasma exchange but who have a high risk for relapse. Approximately 80% of patients survive their acute episode, a survival rate that has not changed since the introduction of plasma exchange treatment. Although recovery may appear to be complete, many patients have persistent minor cognitive abnormalities. More effective as well as safer treatment for TTP is needed.

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Metadata

Authors
George, J. N.
Venue
Blood
Published
2010-11-18
Volume
116
Issue
20
Pages
4060-4069
ISSN
  • 0006-4971 (ISSN-L)
  • 1528-0020
OpenAlex
W2136594380
Cited by
469
References
28
FWCI
14.40
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: How I treat patients with thrombotic thrombocytopenic purpura: 2010. https://app.cochat.ai/papers/10.1182/blood-2010-07-271445
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George, J. N. (2010). How I treat patients with thrombotic thrombocytopenic purpura: 2010. Blood. https://doi.org/10.1182/blood-2010-07-271445

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