You have reviewed the film and concur with the finishing of marked red cell fragmentation. Thrombocytopenia is also confirmed.
You contact the A&E doctor who has reviewed the patient and they confirm as history of a possible seizure prompted hospital review. A history of alcohol excess has also been reported by the patient partner.
Patient usually fit and well, no recent travel, no new medications
Further blood tests undertaken include:
Crest – 231
Urea – 9
LDH – elevated
Coagulation screen – PT 12 APTT 33 fibrinogen 3.4
Trop T- elevated
Amylase – within normal range
Hep B/Hep C/ HIV – negative
ADAMTS13- awaited as not available out of hours in your area
What is your differential diagnosis?
How would you manage this patient?
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