Thrombocytopenia and altered mental status in an HIV-positive woman.
We present a case of thrombotic thrombocytopenic purpura (TTP) in a human immunodeficiency virus (HIV)-positive woman with altered mental status. Altered mental status with thrombocytopenia may be due to many causes, including consumptive coagulopathy, systemic lupus erythematosis, infection, and as side effects of commonly used anti-seizure medications. Of these, platelet transfusion is ineffective or specifically contraindicated in the consumptive coagulopathies, including TTP. TTP should be considered in all patients with altered mental status or neurologic dysfunction, thrombocytopenia, and hemolytic anemia to prevent morbidity and mortality.
Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Latha G
LG
Stead
Barbara G
BG
Lock
D000328:Adult; D003221:Confusion / Q000209:etiology*; D003937:Diagnosis, Differential; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D010956:Plasmapheresis; D017713:Platelet Transfusion; D011697:Purpura, Thrombotic Thrombocytopenic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy