My brother in law is having, thrombotic thrombocytopenic purpura (TTP) disease. His platelet count was reduced about to 80000, hemoglobin- 7.8, rbc- 3.2, esr - 150, ldh- 760, etc. He started the treatment at Hospital, Bhubaneswar, Orissa. He had gone through plasma pheresis process 2 Times. After each pheresis process his platelet count, hemoglobin, rbc, ldh,esr, etc comes to the normal range, but after one month gap it relapse this happened twice. So, please suggest me what I have to do now.

Dr. Arijit NagHematologist8yrs exp

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This is indeed a very worrisome problem. I would suggest that you share all the reports so that we can be sure that it is TTP. TTP can be of two main types: Congenital and Acquired. TTP can relapse especially after triggering factors like infections. In congenital TTP, plasma exchange is not required: only plasma infusion is sufficient. However, in acquired TTP, plasmapheresis is very important as it can be life-saving. In recurrent TTP it is important to discuss the treatment options in detail considering the expenses involved. Acquired TTP needs to be treated simultaneously with immunosuppressives (Glucocorticoid, Rituximab) to remove the inhibitory substances that cause the disease. So it is imperative that you consult a Hematologist immediately. In case you want help online, I will? be happy to guide you.  

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