A 38-year-old woman presents with confusion, petechiae and renal impairment. Platelets are 14 x10^9/L, haemoglobin is 82 g/L and blood film shows

Question

A 38-year-old woman presents with confusion, petechiae and renal impairment. Platelets are 14 x10^9/L, haemoglobin is 82 g/L and blood film shows schistocytes. Coagulation studies are normal and pregnancy test is negative. What is the most appropriate management?

Accepted Answer

Urgent plasma exchange with corticosteroids while awaiting ADAMTS13 testing

Answer

Oral iron therapy and outpatient haematology review

Answer

Platelet transfusion as routine first-line therapy

Answer

Warfarin anticoagulation

Answer

Splenectomy before plasma therapy

Thrombotic thrombocytopenic purpura — RACP Adult Medicine MCQ

A 38-year-old woman presents with confusion, petechiae and renal impairment. Platelets are 14 x10^9/L, haemoglobin is 82 g/L and blood film shows schistocytes. Coagulation studies are normal and pregnancy test is negative. What is the most appropriate management?