Timing of plasma exchange therapy for thrombotic thrombocytopenia purpura: a brief clinical observation.

Plasma exchange is the mainstay of therapy for thrombotic thrombocytopenia purpura. In this study, the authors retrospectively examined variables that may predict outcome in 18 patients with thrombotic thrombocytopenia purpura. They found that the time to first plasma exchange from admission and time to first dose of intravenous steroid are important in influencing outcome. A rise in platelets and a fall in lactic dehydrogenase 3 days after plasma exchange were also found useful in predicting survival. Therefore, early recognition and intervention in this disease is warranted.