Q: Which of the following are the treatment of refractory Thrombotic thrombocytopenic purpura(TTP)? 

A) Plasma Exchange 
B) Glucocorticoids
C) Rituximab 
D) All of the above


Answer: D

The objective of above question is to bring in attention the benefit and use of Rituximab in the treatment of TTP, particularly in refractory cases. Those patients who do not respond to daily Plasma Exchange along with the addition of glucocorticoids or who relapse right after the Plasma Exchange is stopped. Addition of Rituximab may do the trick.