A 26-year-old woman complains of the acute onset of anuria, purpura, and mental confusion. Her peripheral blood film displays marked thrombocytopenia and abundant schistocytes. Laboratory studies reveal elevations of bilirubin, creatinine, and lactose dehydrogenase. A skin biopsy shows numerous intravascular thrombi within the dermal microvasculature. What is the most likely diagnosis?

Question

Quizplus · Accepted Answer

The symptoms and laboratory findings are consistent with thrombotic thrombocytopenic purpura (TTP), which is characterized by thrombocytopenia, microangiopathic hemolytic anemia (schistocytes), renal impairment, neurological symptoms, and fever.  Thrombotic thrombocytopenic purpura is an acute microangiopathic hemolytic anemia. The clinical picture usually includes mental alterations, anuria, mucosal bleeding, and purpura. An abnormal platelet aggregating substance is the likely initiating event.

A 26-Year-Old Woman Complains of the Acute Onset of Anuria