Systemic lupus erythematosus induced thrombotic thrombocytopenic purpura treated with plasma exchange combined with high-dose steroid pulse therapy: a case report

Objective To analyze the clinical outcomes of a patient with thrombotic thrombocytopenic purpura(TTP) as the starting performance who was considered as systemic lupus erythematosus(SLE) under multiple abnormal autoantibodies, and summarize the treatment experience through the clinical outcomes of plasma exchange combined with high-does steroid pulse therapy. Methods A middle-aged female patient presented with initial symptoms of fever, bleeding and hemolytic thrombocytopenia. Laboratory tests showed decreased activity of thrombospondin type 1 motif no.13(ADAMT13) and abnormal autoantibodies. The diagnosis was considered SLE with TTP, and the patient underwent continuous plasma exchange combined with high-dose steroid pulse therapy. The patient's platelet recovery was dynamically observed. Results The patient responded well to plasma exchange combined with high-does steroid pulse therapy, with platelet count raising to normal in a short period of time and hormone gradually decreasing. There was no recurrence during the follow-up period. Conclusion TTP combined with lupus is not common, but when both occur simultaneously, plasma exchange combined with high-does steroid pulse therapy may effectively alleviate symptoms. This treatment approach can serve as a valuable reference for similar clinical cases.