Rituximab como terapia auxiliar para púrpura trombocitopênica trombótica refratária ao tratamento com plasmaférese: Relato de caso

The treatment of choice for thrombotic thrombocytopenic purpura, a disorder in platelet aggregation with inordinate hemolysis and microvascular occlusion, consists of plasmapheresis and corticosteroids. However, there are cases refractory to this therapy and Rituximab, a monoclonal anti-CD20 antibody appears to be an alternative. We report a case of a 35-year-old woman with signs of bleeding and neurological impairment, who underwent plasmapheresis, and after developed hemodynamic instability. After trying plasmapheresis without success, Rituximab was administered 375mg / m², associated with plasmapheresis. She evolved with clinical and laboratory improvement. Rituximab appears to be an option in cases of refractory TTP, but randomized controlled trials are still needed to better establish its role.