Bortezomib induces long term remission in children with immune
thrombotic thrombocytopenic purpura, refractory to plasma exchange,
glucocorticoids, and rituximab: a report on two cases
Abstract
Acquired thrombotic thrombocytopenic purpura (TTP) in children is a rare
but severe disease, which is caused by Immunoglobulin G antibodies,
which inactivate a disintegrin and metalloproteinase with a
thrombospondin type 1 motif, member 13 (ADAMTS13). Daily high-volume
plasma exchange (PEX) and immunosuppression with glucocorticoids and
rituximab is the current standard of treatment for TTP. We report two
females aged 5 and 12 years, with TTP, induced by anti-ADAMTS13
inhibitory antibodies who relapsed very shortly after PEX, rituximab and
glucocorticoids, in whom long-term remission with disappearance of
ADAMTS13 inhibitors was achieved after one course of bortezomib.