Thrombotic Thrombocytopenic Purpura (TTP).
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Today, we have a 35 year old African American female with a past medical history of hypertension, who presents to the emergency department.

He has a two week history of a viral upper respiratory symptoms, including a low grade fever, cough, nasal congestion, rhinorrhea, sore throat, decreased oral intake - followed by a persistent nose bleed.

The nose bleed began over the last couple days and isn't stopping despite persistent pressure. And over the last 24 hours, she had a change in her mental status per her family.

Her exam was unremarkable.

Her vitals: 100.2 F, HR 90s, BP 145/82, and 98% O2 RA. 

Initial labs revealed:

• WBC: 18,000
• H/H: 9/27
• Platelets: 7,000
• Creatinine: 1.4
• Total bilirubin: 3
• LDH: 1,500
• Normal fibrinogen, D-dimer, PT, INR
• Peripheral smear: moderate schistocytes

What's your diagnosis?

Well, at this point, we are thinking Thrombotic thrombocytopenic purpura (TTP).

Today, we are going to break this disease down for you.

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