Somali Medical Forums
Medical Student Forums => Problem-Based Learning Center => Topic started by: Muna1 on December 25, 2007, 08:12:52 PM
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A 64-year-old female is brought to the Emergency Department by her family, who are concerned about her increasing confusion over the past 2 days. On examination she is found to be pyrexial at 38؛C. Blood tests reveal:
Hb 9.6 g/dl
Platelet s65 * 109/l
WCC 11.1 * 109/l
Urea 23.1 mmol/l
Creatinine 366 µmol/l
What is the most likely diagnosis?
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It looks like, Thrombotic thrombocytopenic purpura (TTP)
Classically, the following five symptoms are indicative of this elusive disease: Fluctuating neurological symptoms, such as bizarre behavior, altered mental status, (confusion over the past 2 days)
Stroke or headaches (65%)
Kidney failure (46%); Urea 23.1 mmol/l, Creatinine 366 µmol/l
Fever (33%); pyrexial at 38؛C
Thrombocytopenia, Platelet s65 * 109/l
Microangiopathic hemolytic anaemia, Hb 9.6 g/dl
Treatment
Intravenous (IV) plasma exchange, also called plasmapheresis, is the present standard of treatment for TTP. During the plasma exchange, the inhibitory antibodies are removed and the plasma is replenished with the deficient protease.
hope this is the correct unswer
Kassim
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well done kasem.it is correct
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Congrats, 15 points of this case goes to Kassim