A person presents with fever and altered consciousness. Investigations reveal anemia with fragmented red blood cells, platelet count of 20,000/mm', serum creatinine of 3.0 mg % and normal PT and aPTT. Which of the following is the most appropriate treatment for the patient:
Plasma Exchange Therapy
Coicosteroids and Intravenous
Immunoglobulins
Anticoagulation with Heparin
Answer is A (Plasma Exchange Therapy): Plasma Exchange Therapy is the treatment of choice for TTP Pentad of Fever, Microangiopathic Hemolytic Anemia, Thrombocytopenia (platelets count = 20,000), Renal Failure (I'verum creatinine) and Neurological dysfunction (altered consciousness) together with normal tests of coagulation (normal PT and aPTT) confirms a diagnosis of Thrombotic Thrombocytopenic Purpura. Plasma Exchange .forms the mainstay of treatment of TTP. 'Plasma Exchange remains the mainstay of treatment of TTP'