Pseudo-thrombotic thrombocytopenic purpura: A rare presentation of pernicious anemia.

North American Journal of Medical Sciences
Ashvin K TadakamallaSiddesh Besur

Abstract

Schistocytes are fragmented red blood cells due to the flow of blood through damaged capillaries and indicate endothelial injury. They are typical of microangiopathic hemolytic anemia seen in life threatening conditions like disseminated intravascular coagulation or thrombotic thrombocytopenic purpura/hemolytic uremic syndrome .We report a rare sub-acute presentation of pernicious anemia with hemolysis, thrombocytopenia and numerous schistocytes that was initially diagnosed as a more serious thrombotic thrombocytopenic purpura. A 31-year-old Caucasian woman presented with fatigue and paresthesia of both feet for 1 week. Past medical history included hypertension and gastro-esophageal reflux disease. Examination revealed scleral icterus and pallor. Examination of the abdomen did not show hepatosplenomegaly. Initial laboratory tests showed severe anemia, and low platelets. Indirect bilirubin and serum Lactate De Hydrogenase were elevated. Prothrombin time, partial thromboplastin time, serum fibrinogen, and serum fibrin degradation product levels were normal. Peripheral smear revealed numerous schistocytes, anisocytosis and macro-ovalocytes. Thrombotic thrombocytopenic purpura (TTP) was suspected due to the constellation of sub-ac...Continue Reading

Citations

Mar 19, 2014·Clinical Lymphoma, Myeloma & Leukemia·Dhaval R ShahThein H Oo
Dec 1, 2014·Medicina clínica·Enric ContrerasUNKNOWN por el Grupo Español de Aféresis
Jun 17, 2016·International Journal of Critical Illness and Injury Science·Tanmay S PanchabhaiCharlene K Mitchell
Jul 17, 2016·Clinical and Experimental Nephrology·Hideki KatoUNKNOWN Joint Committee for the Revision of Clinical Guides of Atypical Hemolytic Uremic Syndrome in Japan
Oct 22, 2016·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Daniel W AbbottMatthew S Karafin
Jul 28, 2016·Pediatrics International : Official Journal of the Japan Pediatric Society·Hideki KatoUNKNOWN Joint Committee for the Revision of Clinical Guides of Atypical Hemolytic Uremic Syndrome in Japan
May 6, 2017·Case Reports in Hematology·Ramesh Kumar PandeyBikash Bhattarai
Jul 7, 2020·BMJ Case Reports·Peiting ChenJen Chin Wang
Aug 2, 2017·Case Reports in Hematology·Zurab AzmaiparashviliCatiele Antunes

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