F by removing the blood Lterer Andor dam Interred red Blutk rperchen The spleen splenectomy macrophages.Consequently can help create a gr Ere number of PRI, then a rapid improvement of LTP account, but thanks to this mechanism decreasePLThyperaggregability f rdern splenectomymaynot microthrombi formation and that the deterioration of the h dermatological status and pl USEFUL Todesf ll in this DCC-2036 context, some patients reported explained Ren k nnte. Interestingly, our results show that the activity T significantly reduced ADAMTS either cyclophosphamide or splenectomy remained in four patients, despite the improvement in PLT count and LDH level. This paradoxical observation was reported in patients with TPE t Resembled treated patients, does not stay where ADAMTS activity T be detected by treating every day of PLT-Z Hlung and LDH levels began to improve.
A m Possible explanation Tion is that both methods a slight increase in the activity parp1 of ADAMTS-t, which is sufficient to TTP is to improve in a few days, but not enough to be detected by standard tests to erm Resembled . In these patients, more specific assays for the evaluation of the activity Be applied between the ADAMTS. Torange should confirm to this hypothesis. It should be noted, bacteria were Chemistry one hour INDICATIVE entered complication in our patients, and k Can the dinner of the association of several immunosuppressive procedures have to. Consequently, infectious Se complications due consideration in these immungeschw Want included patients may need during the acute phase the disease, but also in the long-term monitoring.
Another interesting observation from our study is the apparent absence of complications after PLT transfusion. In fact, nine patients again U PLT infusions before splenectomy or cyclophosphamide with no apparent immediate complications. Like other groups that the prejudice caused by transfusions in patients with TTP PLT proposed defied, can safely PLT Andarine infusion in patients with TTP, requiring surgery to reduce bleeding complications are proposed. In this context, the concomitant use of TPE, the risk of side effects associated with reduced PLT infusions connected. We have here the patients with severe disease, antibodymediated, ADAMTS deficiency as the most suitable candidates for splenectomy Andor pulses of cyclophosphamide, the antique car To eliminate body considered.
In fact, we have not f Rdern the treatment of patients with normal activity T or detectable ADAMTS our salvage therapy, because these patients has been reported that a specific profile, with more severe renal involvement, thrombocytopenia have identified shallow and probably other mechanisms involved in the TMA. However, if these strategies be effective k nnte In patients with detectable ADAMTS network or ordinary activity T again unknown and requires further evaluation hei t it. We initially treated patients with severe acquired TTP as recommended on the basis of empirical limited clinical experience Highest. Our results suggest that cyclophosphamide and splenectomy two salvage therapies that offer significant remission rates in severe TTP with a rapid improvement in PLT number and LDH levels are. As salvage therapies Including Lich other t Resembled twice TPE in patients with more severe disease considered to be out Ant lives that do not improve in the short term, the ra