We have a 34 year-old female patient who has presented with headache, thrombocytopenia (plt 25) and intracranial haemorrhage requiring a decompressive craniectomy which was supported with 2 pools of platelets pre-operatively and a further pool intra-operatively. She is now on the neurosurgical ICU and is stable, but remains intubated and ventilated.
You have collated other results:
U&Es, LFTs, bone profile, CRP all normal
Coag screen: PT 13, APTT 35, Clauss Fibr 4.1 (within normal ranges for your lab)
Film: True thrombocytopenia. No fragments, no primitive cells. No large platelets. No clear morphological cause for thrombocytopenia ?ITP
You have also collected some more information from GP records:
No significant past medical history, no regular meds, no known alcohol excess
Only recent GP record (13 days ago) is for her first ChAdOx1 nCoV-19 (AstraZeneca) vaccine
Are there any further investigations you would suggest?
Would you consider any other treatment at this time?