We report the case of a patient diagnosed with a clinical relapse of acquired immune-mediated thrombotic thrombocytopenic purpura (TTP) who was successfully treated with low-dose rituximab plus corticosteroids without the use of plasma exchange (PEx), which was unavailable at the time due to the COVID-19 pandemic. Rituximab 100 mg weekly for 4 weeks was administered, combined with 1 mg/kg of prednisone, obtaining a complete hematological response in 6 weeks. This case suggests that PEx may be unnecessary for a subset of patients with relapsed TTP who are clinically stable without significant end-organ damage. A brief literature review regarding TTP patients treated without plasma exchange is also included.
Multiple therapies have been tested on the present pandemic. Convalescent plasma (CP) is being empirically applied on different trials as a possible treatment to avoid severe presentations of coronavirus disease-19. These treatments have been used before for other infectious diseases with controversial results. The study of this virus is still ongoing, and new information is being gathered daily that could upgrade the approach to get new solutions. Up to this day, vaccines are the most promising therapy to avoid infection, but no successful therapy has been found to cure the actual disease. As we present in this paper, there is controversial information on CP. Still, due to the actual global situation, the medical guild has needed to learn empirically on the road of treating the patients. Results are shown of the most relevant trials that have been made. Furthermore, we mention the trials that are not yet finished for further review.
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