Use of cyclophosphamide in the treatment of thrombotic thrombocytopenic purpura complicating systemic lupus erythematosus: report of two cases

Thrombotic thrombocytopenic purpura (TTP) is an unusual complication of sys temic lupus erythematosus (SLE). There are no randomized, prospective studi es of its treatment. The association of plasma infusions and (or) plasmaphe resis with steroids improves survival when compared with steroid treatment alone, but these patients still have a higher mortality than those with "cl assic" TTP. The role of immunosuppressive drugs in the management of this d isorder remains uncertain. We report two cases of TTP in SLE which presumab ly benefited from the addition of cyclophosphamide to the treatment with pl asmapheresis and steroids.