Citation

Oregel KZ, Ramdial J, Glück S. Clinical Medicine Insights: Blood Disorders 2013; 6: 19-22.

Copyright

(Copyright © 2013)

DOI

10.4137/CMBd.s12843

PMID

unavailable

Abstract

A 21-year-old male presented to the emergency department after a 5-day history of recurrent vomiting and decreased urine output. History revealed ingestion of ibuprofen. During the diagnostic workup, the following was identified: white blood cell count 13.4 (×10(3)/mcL), hemoglobin 11.9 (×10(6)/mcL) with an MCV of 73 fL, hematocrit 34% and platelets were 31,000/mcL, sodium of 130 mmol/L, potassium of 5.1 mmol/L, chloride of 83 mmol/L, bicarbonate of 21 mmol/L, blood urea nitrogen of 184 mg/dL and creatinine of 19.1 mg/dL. He was later diagnosed with thrombotic throm-bocytopenic purpura (TTP) based on the fact that he presented with most components of the TTP pentad (except for fever), which included altered mental status, acute kidney injury, thrombocytopenia, and evidence of red cell fragmentation and his ADAMTS13 level was found to be less than 10% prior to therapy. Te patient then received plasma exchange, oral corticosteroids, and hemodialysis, which led to a full recovery of platelet count and renal function. © the authors, publisher and licensee Libertas Academica Limited.

Language: en

Keywords

adult; human; mental health; male; case report; cannabis; thrombotic thrombocytopenic purpura; hemodialysis; drug use; suicide attempt; drug overdose; cocaine; Ibuprofen; alcohol consumption; article; vomiting; psychologic assessment; thrombocytopenia; physical examination; emergency ward; hospital discharge; nausea; drug withdrawal; urinalysis; corticosteroid; proteinuria; hypertension; hematuria; alanine aminotransferase; aspartate aminotransferase; plasmapheresis; bicarbonate; sodium; sodium blood level; creatinine; creatinine blood level; enzyme blood level; leukocyte count; potassium; potassium blood level; adjustment disorder; ibuprofen; infusion fluid; lactate dehydrogenase; kidney function; urea nitrogen blood level; kidney injury; renal replacement therapy; mean corpuscular volume; hemoglobin; medical history; thrombocyte count; bilirubin; bilirubin blood level; hemoglobin blood level; alanine aminotransferase blood level; aspartate aminotransferase blood level; vital sign; urine volume; hepatomegaly; petechia; prednisone; hyperbilirubinemia; liver function test; alkaline phosphatase blood level; abnormal laboratory result; hematocrit; rehydration; serum osmolality; NSAIDs; lactate dehydrogenase blood level; bicarbonate blood level; appendectomy; alkaline phosphatase; chloride; haptoglobin; Drug-induced TTP; eye jaundice; smear; Thrombotic thrombocytopenic purpura; TTP; von Willebrand factor cleaving proteinase