Thrombotic thrombocytopenic purpura (TTP) with early exacerbation: Case report and intensified therapeutic management with Rituximab in Nicaragua
DOI:
https://doi.org/10.62407/msp6gk40Keywords:
Thrombotic Thrombocytopenic Purpura (TTP), Transmembrane protein on the surface of B lymphocytes (Anti-CD20), Recambio plasmático terapéutico (RPT), Therapeutic Plasma Exchange (TPE)Abstract
Introduction: Thrombotic thrombocytopenic purpura is a rare disease that forms part of thrombotic microangiopathy caused by ADAMTS13 protein deficiency, with a mortality rate of 90% without treatment. In Nicaragua, quantification of this protein is not available; therefore, high clinical suspicion should be considered in the presence of hemolytic anemia, thrombocytopenia, and schistocytes in peripheral blood. Case report: The clinical case of a 46-year-old woman is presented, who required admission to the intensive care unit due to multiple organ failure (hematological, renal, neurological, and ventilatory). Clinical relevance: The case highlights the efficacy of combination therapy (TPE + steroids + Rituximab) as a timely rescue treatment for exacerbation, a vital approach in contexts with diagnostic limitations such as the absence of the ADAMTS13 test.
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