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
Questions:
- What is the next course of management?
- How long would you continue plasma exchange?
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