Thrombotic thrombocytopenic purpura (TTP) is a rare disease causing a critical condition often involving multisystems and having a high mortality rate. The mainstays of treatment being plasma exchange (PEX) and corticosteroids . Refractory TTP is defined as a failure of platelet response after 5 PEX and corticosteroids therapy. This article reports a patient with refractory TTP who did not improve after a PEX and corticosteroids therapy, but was later successfully treated with rituximab.

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