Thrombotic thrombocytopenic purpura treated with vincristine in a Jehovah′s witness

Walia, Sandeep; Walia, Manmeet S; Walia, Harpreet S.

doi:10.4103/0973-6247.83255

Cited by 11 publications

(13 citation statements)

References 4 publications

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“…There have been four previous case reports of successful management of TTP in Jehovah's Witnesses . Only one report utilized plasma exchange, and the patient received gelatin‐based plasma substitute .…”

Section: Discussionmentioning

confidence: 99%

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Successful management of thrombotic thrombocytopenic purpura in a Jehovah's Witness without plasma exchange

2014

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Thrombotic thrombocytopenic purpura (TTP) is a hematologic emergency characterized by microangiopathic hemolytic anemia and thrombocytopenia. Plasma exchange is the standard treatment. Treating TTP without plasma exchange is a challenge. Due to religious beliefs, Jehovah's Witnesses do not accept transfusions of blood products. We report a case of successful treatment of TTP in a Jehovah's Witness using plasma exchange with albumin replacement.

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Section: Discussionmentioning

confidence: 99%

“…Only one report utilized plasma exchange, and the patient received gelatin‐based plasma substitute . Corticosteroid was used in all cases and vincristine was used in two cases . None of the previously reported patients were treated with rituximab.…”

Section: Discussionmentioning

confidence: 99%

Successful management of thrombotic thrombocytopenic purpura in a Jehovah's Witness without plasma exchange

2014

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“…However, this presents a unique challenge in individuals who are unable to accept plasma due to religious beliefs. With Jehovah's Witnesses, there have been 8 published case reports discussing the successful management of TTP (7 idiopathic, 1 drug related) without the use of TPE (2)(3)(4)(5)(6)(7)(8)(9). There is likely a publication bias with only successful cases being reported.…”

Section: Introductionmentioning

confidence: 99%

Successful Management of Thrombotic Thrombocytopenic Purpura in a Jehovah’s Witness: An Individualized Approach With Joint Decision-Making

Lim

Greenberg

2019

Journal of Patient Experience

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The management of thrombotic thrombocytopenic purpura (TTP) presents a unique challenge in individuals who are unable to accept plasma due to religious beliefs, given that therapeutic plasma exchange (TPE) is the standard of care. A 61-year-old Jehovah’s Witness woman presented to our hospital with neurological symptoms and laboratory findings suggestive of TTP. On admission, she refused transfusion of blood products, specifically red blood cells, platelets, and plasma but accepted albumin and intravenous immunoglobulin (IVIG); fractions of plasma. She was started on steroids, IVIG, and TPE with albumin as replacement therapy with minimal improvement. After a detailed discussion with the patient and family, they agreed to accept cryosupernatant. The patient started TPE with cryosupernatant for replacement therapy, which resulted in clinical improvement. This case highlights the importance of an individualized approach with joint decision-making given the significant heterogeneity that exists in Jehovah’s Witnesses’ attitude toward the receipt of blood products.

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“…Plasma provides ADAMTS13 replacement and reduces risk of bleeding due to depletion of coagulation factors. There are a few reports of various alternative strategies to PLEX, including use of plasma exchange with albumin, chemotherapeutic agents such as vincristine, rituximab and/or steroids (Drummond et al ., ; Dabak et al ., ; Walia et al ., ; Chai et al ., ). We report the successful management of TTP in a Jehovah's Witness patient using pegylated bovine carboxyhaemoglobin (Sanguinate™, Prolong Pharmaceuticals, Inc., South Plainfield, NJ, USA) as an adjunct medication.…”

mentioning

confidence: 99%

Pegylated bovine carboxyhaemoglobin utilisation in a thrombotic thrombocytopenic purpura patient

Sam

Desai

Laber

et al. 2017

Transfusion Medicine

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Thrombotic thrombocytopenic purpura treated with vincristine in a Jehovah′s witness

Cited by 11 publications

References 4 publications

Successful management of thrombotic thrombocytopenic purpura in a Jehovah's Witness without plasma exchange

Successful management of thrombotic thrombocytopenic purpura in a Jehovah's Witness without plasma exchange

Successful Management of Thrombotic Thrombocytopenic Purpura in a Jehovah’s Witness: An Individualized Approach With Joint Decision-Making

Pegylated bovine carboxyhaemoglobin utilisation in a thrombotic thrombocytopenic purpura patient

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