Department of Hematology, Tokyo Women's Medical University, Japan.
Intern Med. 2021 Sep 1;60(17):2859-2862. doi: 10.2169/internalmedicine.6387-20. Epub 2021 Mar 29.
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/m) 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.
我们在此报告两例血栓性血小板减少性紫癜（TTP）合并其他自身免疫性疾病的病例，分别为自身免疫性肝炎和免疫性血小板减少症。在这两种情况下，均持续给予皮质类固醇治疗先前的自身免疫性疾病。然而，血浆置换和皮质类固醇治疗并未使 TTP 获得足够的客观反应。在诊断后 2 周内，开始每周一次利妥昔单抗（375mg/m）治疗，共 4 次。两名患者均获得了充分的反应，截至最后一次随访日期，均未复发。在 TTP 合并其他自身免疫性疾病的患者中，早期引入利妥昔单抗可能是一种有效的治疗选择。
