Case 7 – update 5

We are now sure the patient has TTP.  Results of previously requested investigations show:

  • Viral screen (HIV/Hep B/C) – negative
  • Autoimmune screen – negative
  • CXR – lung fields clear, heart size normal, no obvious bone or soft tissue abnormality
  • ECG – no ischaemic changes
  • Troponin and amylase – not elevated
  • ADAMTS13 <5%
  • CT Chest/abdo/pelvis – requested

The patient had had three days of plasma exchange and his FBC is as follows:

WCC 7.5 x10*9/L

Hb 99g/L

PLT 65 x10*9


  • What is the next course of management?
  • How long would you continue plasma exchange?

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