Labs

• Platelet count: 9 x 103/mm3 (9 x 109/L) (normal 140-440 x 103/mm3 [140-440 x 109/L])

• Haptoglobin 15 mg/dL (150 mg/L) (normal 30-200 mg/dL or 300-2,000 mg/L)

• LDH 1,950 units/L (32.5 pkat/L) (normal 100-250 units/L, or 1.67-4.17 pkat/L)

• Hemoglobin 6 g/dL (60 g/L or 3.72 mmol/L) (normal 12. 1-15.1 g/dL or 121-151 g/L or 75-9.36 mmol/L)

• Blood peripheral smear: numerous schistocytes (11-12 per high power field) Given this additional information, is this patient's presentation consistent with TTP? What is the likely etiology of this patient's TTP?

Identify your treatment goals for this patient.

Pharmacologic Therapy Corticosteroids

Corticosteroids can be used for their immunosuppressive effect in combination with PEX; however, they are not efficacious as monotherapy in TTP. The most commonly used agents are methylprednisolone 1 g/day IV for 3 days and prednisone 1 to 2 mg/ kg/day orally for the duration of PEX therapy.

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