Successful Rituximab Treatment in Thrombotic Thrombocytopenic Purpura Patients Complicated by Other Autoimmune Disorders: Two Case Reports

Aya Watanabe; Masayuki Shiseki; Megumi Oishi; Maya Kobayashi; Shoko Oshima; Satoko Osanai; Michiko Ryuzaki; Yuki Izuka; Norina Tanaka; Midori Ishiyama; Akihito Shinohara; Hiroshi Kazama; Shotaro Hagiwara; Kentaro Yoshinaga; Junji Tanaka

doi:10.2169/internalmedicine.6387-20

This article has now been updated. Please use the final version.

Successful Rituximab Treatment in Thrombotic Thrombocytopenic Purpura Patients Complicated by Other Autoimmune Disorders: Two Case Reports

Aya Watanabe, Masayuki Shiseki, Megumi Oishi, Maya Kobayashi, Shoko Oshima, Satoko Osanai, Michiko Ryuzaki, Yuki Izuka, Norina Tanaka, Midori Ishiyama, Akihito Shinohara, Hiroshi Kazama, Shotaro Hagiwara, Kentaro Yoshinaga, Junji Tanaka

Author information

Aya Watanabe
Department of Hematology, Tokyo Women's Medical University, Japan
Masayuki Shiseki
Department of Hematology, Tokyo Women's Medical University, Japan
Megumi Oishi
Department of Hematology, Tokyo Women's Medical University, Japan
Maya Kobayashi
Department of Hematology, Tokyo Women's Medical University, Japan
Shoko Oshima
Department of Hematology, Tokyo Women's Medical University, Japan
Satoko Osanai
Department of Hematology, Tokyo Women's Medical University, Japan
Michiko Ryuzaki
Department of Hematology, Tokyo Women's Medical University, Japan
Yuki Izuka
Department of Hematology, Tokyo Women's Medical University, Japan
Norina Tanaka
Department of Hematology, Tokyo Women's Medical University, Japan
Midori Ishiyama
Department of Hematology, Tokyo Women's Medical University, Japan
Akihito Shinohara
Department of Hematology, Tokyo Women's Medical University, Japan
Hiroshi Kazama
Department of Hematology, Tokyo Women's Medical University, Japan
Shotaro Hagiwara
Department of Hematology, Tokyo Women's Medical University, Japan
Kentaro Yoshinaga
Department of Hematology, Tokyo Women's Medical University, Japan
Junji Tanaka
Department of Hematology, Tokyo Women's Medical University, Japan

Keywords: thrombotic thrombocytopenic purpura, autoimmune hepatitis, immune thrombocytopenia, rituximab, ADAMTS13

JOURNAL OPEN ACCESS Advance online publication

Article ID: 6387-20

DOI https://doi.org/10.2169/internalmedicine.6387-20

The final version of this article is now available: Vol. 60 (2021), No. 17 pp. 2859-2862

Details

Abstract

We herein report two cases of thrombotic thrombocytopenic purpura (TTP) complicated by other autoimmune disorders, autoimmune hepatitis and immune thrombocytopenia, respectively. In both cases, corticosteroids were continuously administered for the treatment of preceding autoimmune disorders. However, a sufficient objective response for TTP was not obtained by plasma exchange and corticosteroid treatment. Once a week rituximab (375 mg/m²) treatment for 4 times was initiated within 2 weeks from the diagnosis. Both patients achieved a sufficient response, and have never had any recurrence as of the last follow-up dates. The early introduction of rituximab could be an effective treatment option in TTP patients complicated with other autoimmune disorders.

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