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View Full Version : Is there a Hematologist in the house? MC's daughter has TTP?



rwam
05-26-2007, 05:58 PM
I have a question about TTP. In my WIP, my MC's daughter has TTP. She started showing symptoms on Day 1, started getting plasma exchange therapy on Day 4 and her platelet counts continue to drop through Day 12. On Day 13 her hematologist puts her on steroids and Vincristine. She's having seizures that are getting worse and also bleeds (a little) from her eyes. Her hematologist will give her until Day 14 and if the steroids and Vincristine don't work, he'll have her spleen removed.

My question is....I need to raise the stakes. Have I got the progression of treatment correct? Should she have already had a splenectomy by Day 13? The treating physician has already admitted he should have started the Vincristine earlier, so if that's a problem, I have it covered.

I read that Renal Failure is common for TTP patients. I'm thinking about keeping things as they are (least invasive at this point) and having her go into acute renal failure. Question is, can this be staved by dialysis? And if so:
a) Can even dialysis not be enough?
b) Would they still bother doing a splenectomy if a person was on dialysis?

Any insight would be helpful.