Case Report of Thrombotic Thrombocytopenic Purpura in a Previously Healthy Adult

Jessica L Sea, PhD, Stephen F Gassner, MD, MPH and Jonathan Smart, MD

doi:https://doi.org/10.21980/J8VK9M

Case Report of Thrombotic Thrombocytopenic Purpura in a Previously Healthy Adult

Jessica L Sea, PhD^*, Stephen F Gassner, MD, MPH^* and Jonathan Smart, MD^*

^*University of California, Irvine, Department of Emergency Medicine, Orange, CA

Correspondence should be addressed to Jon Smart, MD at jsmart1@hs.uci.edu

DOI: https://doi.org/10.21980/J8VK9M Issue 6:1

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ABSTRACT:

This case report details the presentation of a 24-year-old male presenting with headache, palpitations, gingival bleeding, and pallor. The ultimate diagnosis of thrombotic thrombocytopenic purpura (TTP) is a rare but life-threatening condition which is typically hallmarked by thrombotic microangiopathy (TMA) and dysfunctional ADAMTS13 enzymatic activity. This patient displayed classically described findings, including marked anemia, thrombocytopenia, and acutely elevated creatinine as well as a brief period of newly onset word-finding difficulty while in the emergency department. His diminished ADAMTS13 activity level (<5%) and the presence of autoantibodies against ADAMTS13 confirmed a diagnosis of TTP. Fortunately, the patient’s outcome was favorable after treatment with plasmapheresis, prednisone, and rituximab. This case report provides a review of the clinical presentation, diagnostic criteria, potentially confounding differential diagnosis, and expected course of treatment for patients with TTP.