USMLE Forums banner

40-year-old woman with thrombocytopenia

4369 Views 4 Replies 4 Participants Last post by  Taiyakikung
This is my first Thread :))

A 40-year-old woman has had a week long course of fever and mental confusion. Physical examination shows T 38.2 C, P 100/minute, RR 20/minute, and BP 100/60 mm Hg. She has widespread petechiae of skin and mucosal surfaces. Laboratory studies show her serum urea nitrogen is 52 mg/dL with creatinine 5.3 mg/dL. She has a hemoglobin of 12.2 g/dL, hematocrit 36.8%, MCV 93 fL, platelet count 19,000/microliter, and WBC count 8180/microliter. Schistocytes are seen on her peripheral blood smear. Her condition deteriorates rapidly following platelet transfusion. At autopsy, pink hyaline thrombi are found in small myocardial arteries. Which of the following is the most likely diagnosis?

A Disseminated intravascular coagulopathy
B Idiopathic thrombocytopenic purpura
C Thrombotic thrombocytopenic purpura
D Trousseau syndrome
E Warm autoimmune hemolytic anemia
  • Like
Reactions: 5
1 - 1 of 5 Posts
It is TTP/HUS secondary to sepsis.

The hyaline thrombi are typical for TTP, as is the pentad of fever, mental changes, renal failure, thrombocytopenia, and microangiopathic hemolytic anemia. Platelet transfusion is contraindicated.
  • Like
Reactions: 3
1 - 1 of 5 Posts
This is an older thread, you may not receive a response, and could be reviving an old thread. Please consider creating a new thread.