Siddharth Mittal: A Sheet-Like Effluent Deposit During Plasma Exchange in iTTP
Siddharth Mittal, Assistant Professor at Aiims Jodhpur, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in Journal of Clinical Apheresis, adding:
“Caution in the Bag: A Sheet-Like Deposit as a Visual Clue to Systemic Derangement in Immune-Mediated TTP.
Delighted to share our latest case report, published as part of the Apheresis Illustrated series in the Journal of Clinical Apheresis (2026).
During therapeutic plasma exchange (TPE) for a relapsing case of immune-mediated TTP, we observed an unusual, unreported finding – a pale – yellow, sheet-like deposit adherent to the effluent bag, with the bag walls apposed rather than collapsed.
Rather than a single isolated cause, we interpret this as the visible end – point of overlapping systemic derangements – lipemia, a surging acute – phase response, and intense coagulation – fibrinolytic activation – converging during active thrombotic microangiopathy.
It’s a reminder that even something as routine as an effluent bag can carry a visual signature of a patient’s underlying biochemical turmoil – and that careful, prospective documentation of such findings across centers can add real diagnostic value.”
Title: Caution in the Bag: A Sheet-Like Deposit as a Visual Clue to Systemic Derangement in Immune-Mediated TTP
Authors: Taniya Kapoor, Sathish Saravanan, Durga Shankar Meena, Parmatma Prasad Tripathi, Siddharth Mittal
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