A 55-year-old man on ICU develops thrombotic thrombocytopenic purpura (TTP). His ADAMTS13 activity level returns at ...

Question

A 55-year-old man on ICU develops thrombotic thrombocytopenic purpura (TTP). His ADAMTS13 activity level returns at

Accepted Answer

Plasma exchange (PEX/TPE) - this is the cornerstone of TTP treatment; it removes the pathogenic anti-ADAMTS13 autoantibodies and ultra-large vWF multimers while replacing functional ADAMTS13; it should be commenced URGENTLY (within hours of diagnosis) as untreated TTP has >90% mortality

Answer

Platelet transfusion

Answer

IV heparin

Answer

Oral prednisolone 5 mg daily

Answer

Observation only

uk-fficm MCQ (SBA): TTP - Plasma Exchange

A 55-year-old man on ICU develops thrombotic thrombocytopenic purpura (TTP). His ADAMTS13 activity level returns at <5%. He has: MAHA (schistocytes on film), thrombocytopenia (platelets 12 × 10⁹/L), AKI, altered mental status, and fever. What is the immediate first-line treatment?