WHAT IS THE TREATMENT FOR TTP-HUS?
Plasma exchange is the most important treatment for all patients except young children whose illness follows diarrhea; they usually get well without plasma exchange. It is done with a machine that removes patient plasma and replaces it with fresh plasma, similar to the machines used for routine blood donations. The reason for the effectiveness of plasma exchange, like the cause of the disease, is not known. The exchange may remove a harmful substance from the patient and provide an essential new substance in the fresh plasma. Plasma exchange has risk. A catheter needs to be inserted into one of the large veins of the shoulder, neck, or groin area. That creates a risk for serious infection. Allergic reactions to the infused plasma are common; most reactions cause only hives, but some can also cause breathing problems.
We continue plasma exchange daily until the platelet count is normal. Then we may decrease treatments to every other day, or we may stop. However if the TTP-HUS is still active, the platelet count will fall again and daily treatments must be resumed. Patients usually get better in several days and then need one to three weeks of treatment to make sure that they stay well. Other treatments, such as steroids and related medicines, are sometimes also used to help patients recover more quickly.
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