Case 114 – Update 2!

As highlighted by our followers the patients degree of bruising is out of proportion to a platelet count of 51. As requested a thrombin time and ddimer have been performed and are both prolonged.

Thrombin time: 19 Ddimer 6320 (reminder: PT 27, APPT 45, Clauss Fib 0.9)

We’ve also been informed that the patient is also developing new mucosal blood blisters. A repeat FBC is more deranged Hb 95, plts 34, WCC 3.6, Neuts 0.6. Film still not diagnostic. Viral screen as requested already in progress.

Questions:

  1. What is the explanation for the clotting results?
  2. How would you want to further investigate this progressive pancytopenia and above deranged clotting?

 

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