Abstract
A 75 year old female presented to the family medicine clinic with complaints of fatigue, intermittent epigastric pain, decreased appetite with associated weight loss, easy bruising, and bilateral hand tremors. Physical exam was positive for scattered bruising, but otherwise benign. Initial differential diagnoses included hypothyroidism, anemia, vitamin or mineral deficiency, sleep apnea, malignancy, and tick-borne illness. Preliminary labs were drawn in clinic. The patient presented to the Emergency Department within 2 hours of leaving the clinic due to stroke-like symptoms. Workup revealed markedly low platelets with schistocytes identified on peripheral blood smear. PLASMIC score was applied, which indicated a high probability of thrombotic thrombocytopenic purpura (TTP). Thrombotic thrombocytopenic purpura can present with a constellation of vague symptoms, including easy bleeding, weakness, and neurologic, abdominal, and cardiac complaints. While the patient’s age made this diagnosis less likely than other differentials, it highlights the importance of having a high index of suspicion for this disease. Prompt diagnosis and treatment is necessary for lowered morbidity and mortality.
Recommended Citation
Kitzmann, Rachel K.
(2024)
"Fatal Fatigue: Thrombotic Thrombocytopenic Purpura,"
SIU Journal of Medical Science Scholarly Works: Vol. 2:
Iss.
1, Article 3.
Available at:
https://opensiuc.lib.siu.edu/jmssw/vol2/iss1/3