A 34-year-old woman presents with confusion, petechiae and fatigue. Hemoglobin is 74 g/L, platelets are 12 x 10^9/L, creatinine is 142 micromol/L,

Question

A 34-year-old woman presents with confusion, petechiae and fatigue. Hemoglobin is 74 g/L, platelets are 12 x 10^9/L, creatinine is 142 micromol/L, LDH is high and haptoglobin is undetectable. Blood film shows schistocytes. Coagulation tests are normal. What is the most appropriate management?

Accepted Answer

Urgent plasma exchange plus corticosteroids

Answer

Observation until ADAMTS13 returns

Answer

Therapeutic phlebotomy

Answer

Platelet transfusion as routine first-line therapy

Answer

Vitamin K and fresh frozen plasma alone

Thrombotic thrombocytopenic purpura — RCPSC IM MCQ

A 34-year-old woman presents with confusion, petechiae and fatigue. Hemoglobin is 74 g/L, platelets are 12 x 10^9/L, creatinine is 142 micromol/L, LDH is high and haptoglobin is undetectable. Blood film shows schistocytes. Coagulation tests are normal. What is the most appropriate management?