Open AccessThrombotic thrombocytopenic purpura in a patient with HIV from Zimbabwe
Author(s) -
Michael Marks,
Zaheer Mangera,
Paul Cervi
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.05.2009.1854
Subject(s) - medicine , thrombotic thrombocytopenic purpura , fresh frozen plasma , platelet , schistocyte , purpura (gastropod) , gastroenterology , complete blood count , coagulation testing , human immunodeficiency virus (hiv) , thrombocytopenic purpura , pediatrics , surgery , immunology , ecology , biology
A woman in her 40s originally from Zimbabwe presented to our accident department in the UK with a 4 day history of menorrhagia and exertional chest pain. Her clinical examination was unremarkable. Routine blood tests revealed a haemoglobin value of 6.8 g/dl and a platelet count of 15×10(9)/l, with normal renal function and coagulation profile. Blood film showed microangiopathic haemolytic anaemia and thrombocytopenia. On direct questioning, she admitted to being HIV positive, and receiving antiviral therapy at another hospital. A diagnosis of HIV associated thrombotic thrombocytopenic purpura (TTP) was made. The patient was transferred to a tertiary centre for urgent plasma exchange. She required 8 days of 1.5 litre exchanges with solvent detergent fresh frozen plasma (FFP) and high dose steroids. She responded within 24 h with increasing haemoglobin and platelet counts, and at discharge her haemoglobin was 10.7 g/dl and platelet count 253×10(9)/l.