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Thrombotic Thrombocytopenic Purpura

History

The patient is a 45-year-old Hispanic female who felt ill for one week and afterwards claimed she was feeling somewhat better. The patient's husband told the ER clinician that ten days earlier she was seen at another hospital and was diagnosed with a mild upper respiratory tract infection, where the physician prescribed antibiotics. She had also taken over-the-counter cough medication for a week and stated that she seemed to have improved after taking the medication. She also took aspirin to relieve her headache symptoms. She also acknowledged that she experienced persistent vomiting for the past two days and took Pepto-Bismol for her upset stomach.

She denied any family history of hypertension and bleeding disorders. She had no history of diarrhea, asthma, allergies, or peptic ulcer. She had a total abdominal hysterectomy four years prior and she is not currently on estrogen therapy. She stated that she noticed that her urine was bloody. She admits that she bleeds from her gums when brushing her teeth; however, her dentist told her that bleeding gums could be a sign of gingivitis. She was scheduled to see her dentist in two weeks.