Background: Thrombotic thrombocytopenic purpura (TTP) is a rare but deadly thrombotic microangiopathy (TMA) that is caused by ADAMTS13 deficiency. The PLASMIC clinical scoring system was developed and validated to determine the pretest probability of severe ADAMTS13 deficiency in cases of suspected TTP. We studied the role of the PLASMIC score in guiding use of the [...]

Case Presentation: A 55-year-old female with a past medical history of seizure disorder and prior opioid use presented to an outside emergency department with a 1-day history of expressive aphasia and headache. Her NIH Stroke Scale was 4. CT head w/o contrast demonstrated a subacute infarct within the left middle cerebral artery (MCA) territory and [...]

Case Presentation: A 53-year-old male with a history of Goodpasture syndrome, systemic lupus, and Wegener’s granulomatosis underwent a deceased donor kidney transplant for end-stage renal disease. Two days post-surgery, the patient developed anemia and thrombocytopenia, elevated lactate dehydrogenase, and increased creatinine, prompting a preemptive diagnosis of TTP. Plasmapheresis was initiated every other day, alternating with [...]

Case Presentation: This is a unique case of acquired thrombotic thrombocytic purpura (aTTP) due to the novel SARS-CoV-2 virus (COVID-19). Our patient is a 36-year old male with hypertension, alpha-thalassemia trait, who presented with abdominal pain. He has a family history pertinent for a sister with immune thrombocytopenic purpura. He was found to have cholecystitis [...]

Case Presentation: A 29-year-old female Jehovah’s Witness presented with three weeks of easy bruising in the absence of trauma. She also noticed heavier and prolonged menstrual flow associated with fatigue and dizziness. She denied medication use, febrile illnesses or neurologic symptoms. Vital signs were normal. Physical exam revealed multiple ecchymoses on bilateral upper and lower [...]

Case Presentation: A 19-year-old woman presented to an outside hospital with 2-hours of slurred speech and right-sided paresthesia. Her past medical history was significant for obesity and gastric sleeve surgery. Vitals showed blood pressure of 156/98 mmHg, pulse of 96 bpm, respiratory rate of 18 bpm, and oxygen saturation of 100% on room air. The [...]

Case Presentation: A 59-year-old female with a history of type 2 diabetes, hypertension, dyslipidemia, bipolar disorder, and daily alcohol use, presented with acute onset epigastric abdominal pain radiating to the back, nausea and vomiting. Physical examination was notable only for epigastric tenderness. Pertinent labs include neutrophilic leukocytosis, elevated lipase (2353 units/L) and lactic acidosis (2.4 [...]

Case Presentation: A 15 year-old female with obesity presents to the hospital with vomiting, headache, and decreased responsiveness. Prior to arrival she had about 10 episodes of non-bloody vomiting, after which she had altered consciousness. She denied any diarrhea, dysuria, blood in stool, and vaginal bleeding. She denied bleeding and bruising easily. No recent consumption [...]