Stroke Research Today is a free monthly online journal that collates and summarizes the latest research about Stroke, including details on treatment, recovery, rehabilitation, signs, symptoms.

A dramatic response to rituximab in a patient with resistant thrombotic thrombocytopenic purpura (TTP) who developed acute stroke.

Ozdogu H, Boga C, Kizilkilic E, Yeral M, Kozanoglu I, Karatas M

Department of Hematology, Baskent University Faculty of Medicine, 06490 Ankara, Turkey.

BACKGROUND: Refractory condition can occur in 10-30% of all cases of thrombotic thrombocytopenic purpura despite increased frequency of total plasma exchange. Rituximab can affect the clinical outcome of the refractory cases. However, little is known about usefulness of rituximab on central nervous system involvement mimicking acute ischemic stroke. METHODS: We report the case of a woman with refractory thrombotic thrombocytopenic purpura who developed an acute onset right sided paralysis, dysarthria, and central facial paralysis, suggestive of cerebrovascular accident while under plasma exchange, corticosteroid, and vincristine therapy. RESULTS: After initiation of rituximab (375 mg/m(2) weekly for 4 weeks), a dramatic response occurred and the patient's neurologic function recovered fully within days. Sustained remission was achieved, and the patient was well 1 year after her admission, while she was on azathioprine treatment. CONCLUSION: This report suggests that rituximab can provide a good outcome of the dramatic central nervous system involvement in patients with thrombotic thrombocytopenic purpura.

Published 14 March 2007 in J Thromb Thrombolysis, 23(2): 147-50.
Full-text of this article is available online (may require subscription).

© 2004-2008 Stroke Research Today. All Rights Reserved.