Steroids and antiplatelet agents are used. Steroids often are administered prior to plasma exchange. Antiplatelet agents are used, but hemorrhage is a concern and these agents' benefit has not been proven. Aspirin and dipyridamole are recommended by some, but their use is controversial. Splenectomy is performed occasionally to treat patients who do not respond to plasma exchange or that relapse chronically.
Some patients benefit from splenectomy.
The response may be due to the removal of the site of sequestration of the RBCs and platelets. Treatment of refractory or relapsing TTP includes vincristine, a second-line therapy with an unknown mechanism of action. Vincristine is occasionally given to treat resistant cases, but it has no proven benefit. Supportive care for end-organ damage may be required. Hemodialysis is required occasionally for renal failure.