TTP Coexisting SLE Management — ESENeph MCQ
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Correct answer: D — Caplacizumab plus plasma exchange and immunosuppression
The best answer is “Caplacizumab plus plasma exchange and immunosuppression”. NICE recommends caplacizumab with plasma exchange and immunosuppression for acute acquired TTP. Plasma exchange is started urgently, while immunosuppression addresses the anti-ADAMTS13 autoantibody. “Use caplacizumab alone and omit plasma exchange” is less appropriate because caplacizumab is an adjunct and does not replace rapid antibody removal and ADAMTS13 replacement “Wait for spontaneous platelet recovery before treatment” is less appropriate because acquired TTP is life-threatening and requires immediate therapy “Treat with platelet transfusion as definitive routine therapy” is less appropriate because platelet transfusion can worsen microvascular thrombosis and does not treat the mechanism “Use maintenance haemodialysis as the primary TTP treatment” is less appropriate because dialysis supports severe kidney failure but does not treat acquired TTP
Reference: NICE TA667: caplacizumab for acquired TTP: https://www.nice.org.uk/guidance/ta667/chapter/1-Recommendations