A young lady presented with micro-angiopathic hemolytic anemia, thrombocytopenia and reduced level of consciousness. Her ADAMTS level was low and was diagnosed as TTP. She was given plasma exchange to which she responded and then relapses after 1 year. What is the treatment option now?
a. Plasma exchange
b. Plasma exchange plus rituximab
c. Plasma exchange plug splenectomy
d. High dose steroids
Plasma exchange.A kind of hemolysis caused by mechanical injury to the red blood cells is known as microangiopathic hemolytic anaemia (MAHA), which is defined by the presence of red cell fragments (schistocytes) on blood smears.