Case 7 – update 5

We are now sure the patient has TTP.  Results of previously requested investigations show:

  • Viral screen (HIV/Hep B/C) – negative
  • Autoimmune screen – negative
  • CXR – lung fields clear, heart size normal, no obvious bone or soft tissue abnormality
  • ECG – no ischaemic changes
  • Troponin and amylase – not elevated
  • ADAMTS13 <5%
  • CT Chest/abdo/pelvis – requested

The patient had had three days of plasma exchange and his FBC is as follows:

WCC 7.5 x10*9/L

Hb 99g/L

PLT 65 x10*9

Questions:

  • What is the next course of management?
  • How long would you continue plasma exchange?

Please reply on Twitter and always include #teamhaem to allow others to follow your comments. Please join in the debate and learn about haematological emergencies along the way. The case will continue to  evolve over the coming week so keep checking #teamhaem for more information.

Please note – all cases on TeamHaem are entirely fictional to protect patient confidentiality.

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This entry was posted in Acquired bleeding, Anaemia, Platelet disorders and tagged , . Bookmark the permalink.

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