title: Myelodysplastic Syndrome Clinically Presenting with the "Classic TTP Pentad".
abstract: The clinical presentation of myelodysplastic syndrome (MDS) is not specific. Many patients can be asymptomatic and can be detected only due to an abnormal complete blood cell count (CBC) on routine exam or for other reasons while others can be symptomatic as a consequence of underlying cytopenias. Thrombotic thrombocytopenic purpura (TTP) usually is suspected under the evidence of microangiopathic hemolytic anemia (MAHA) and thrombocytopenia and because it is a life-threatening condition (medical emergency) immediate initiation of plasmapheresis could be life-saving. The following case illustrates an unusual presentation of MDS in a patient who came in to the emergency room with the classic TTP "pentad" of fever, renal involvement, MAHA, mental status changes, and thrombocytopenia. We will focus our discussion in the clinical presentation of this case.
authors.affiliation: Department of Hematology and Oncology, The Brooklyn Hospital Center, 121 Dekalb Ave, New York, NY 11201, USA.
authors.forename: Santiago Fabián
authors.identifier: 0000-0002-4487-5314
authors.initials: SF
authors.lastname: Moscoso Martínez
authors.affiliation: Department of Pathology, Hofstra Northwell Health School of Medicine, 6 Ohio Drive, New Hyde Park, NY 11042, USA.
authors.forename: Evelyn Carolina
authors.initials: EC
authors.lastname: Polanco Jácome
authors.affiliation: Department of Hematology and Oncology, The Brooklyn Hospital Center, 121 Dekalb Ave, New York, NY 11201, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Guevara
authors.affiliation: Department of Hematology and Oncology, The Brooklyn Hospital Center, 121 Dekalb Ave, New York, NY 11201, USA.
authors.forename: Vijay
authors.initials: V
authors.lastname: Mattoo