Diagnostic and Treatment Guidelines for Thrombotic Thrombocytopenic Purpura (TTP) 2017 in Japan

Overview

Journal Int J Hematol

Specialty Hematology

Date 2017 May 28

PMID 28550351

Citations 44

Authors

Masanori Matsumoto

Yoshihiro Fujimura

Hideo Wada

Koichi Kokame

Yoshitaka Miyakawa

Yasunori Ueda

Satoshi Higasa

Takanori Moriki

Hideo Yagi

Toshiyuki Miyata

Mitsuru Murata

Affiliations

Soon will be listed here.

Abstract

Thrombotic thrombocytopenic purpura (TTP) can rapidly progress into a life-threatening condition, thus the importance of appropriate diagnosis and treatment cannot be overstated. Until recently, TTP has mainly been diagnosed by clinical findings such as thrombocytopenia and non-immune hemolytic anemia. In addition to these clinical findings, however, reduced activity of a disintegrin-like and metalloprotease with thrombospondin type 1 motif 13 (ADAMTS13) below 10% has been accepted internationally as a diagnostic criterion for TTP. In the present guidelines, we have taken all of these criteria into consideration. TTP is classified as acquired if the patient is positive for anti-ADAMTS13 autoantibodies, and as congenital if ADAMTS13 gene abnormalities are detected. Fresh-frozen plasma (FFP) transfusion is performed in patients with congenital TTP to supplement ADAMTS13. Plasma exchange therapy using FFP is conducted in patients with acquired TTP to supplement ADAMTS13 and remove anti-ADAMTS13 autoantibodies. To suppress autoantibody production, corticosteroid therapy may be administered in conjunction with plasma exchange. Recent reports show that the monoclonal anti-CD-20 antibody rituximab is effective in patients with refractory or relapsed TTP.

Citing Articles

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