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Plasmapheresis with exchange as primary treatment for thrombotic thrombocytopenic purpura.

Thrombotic thrombocytopenic purpura (TTP) is an uncommon disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, fever and renal and neurologic dysfunction. As a result of the availability of plasmapheresis, we can report the results of 5 patients treated with plasmapheresis and exchange transfusion who also received intravenous corticosteroids as adjunctive therapy. Our 5 patients had a mean age of 41 years, and presented with a mean platelet count of 39 x 10(9)/L. Four of the 5 patients responded to treatment and were discharged in excellent condition. The 5th patient succumbed to her disease. We concluded that plasmapheresis with exchange transfusion is a rapid and effective therapy for TTP.