Therapeutic Plasma Exchange as an Adjunct to Renal Replacement Therapy in the Management of Sepsis-Induced Bone Marrow Suppression in a Young Adult Patient: A Case Report

Bone marrow suppression caused by sepsis is a rare yet severe clinical condition, often resulting in multi-organ dysfunction and a high risk of fatality. This report discusses the case of a 16-year-old male with pre-existing diabetes mellitus and hypertension who arrived at the hospital in a comatose state, suffering from respiratory failure, shock, and severe metabolic acidosis. Despite initial stabilization measures, including mechanical ventilation, vasopressor therapy, and hemodialysis, the patient's clinical status continued to decline. Urine toxicology screens identified the presence of amphetamines and benzodiazepines. The medical team then initiated Therapeutic Plasma Exchange (TPE) alongside Renal Replacement Therapy (RRT), which led to a rapid improvement in the patient's neurological, hematological, and metabolic parameters. This case underscores the potential benefit of TPE in managing sepsis-induced bone marrow suppression and highlights the necessity of multidisciplinary collaboration in critical care settings.