Serous retinal detachment as an early presentation of thrombotic thrombocytopenic purpura.
A 23-year-old woman presented with abdominal pain and blurred vision in both eyes. Fundoscopy revealed large bullous detachments of her neurosensory retina with shifting subretinal fluids bilaterally. Laboratory studies showed a hemoglobin of 6.5 mmol/l, thrombocytes 20x10(9)/l, and LDH 1098 U/l. A peripheral blood smear revealed red blood cell fragmentation. A diagnosis of thrombotic thrombocytopenic purpura was made. The patient was treated with four sessions of plasmapheresis followed by plasma infusions, which resulted in a complete recovery.
Nanayakkara
P
Department of Internal Medicine, University Hospital Vrije Universiteit, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
Gans
RO
Reichert-Thoen
J
ter Wee PM