Case of a Woman with TPP and Multiple Comorbidities

A 44-year-old woman with a history of HIV, type 2 diabetes mellitus (T2DM), gastroesophageal reflux disease (GERD), thrombotic thrombocytopenic purpura (TTP), and hepatitis C presents with abdominal pain, malaise, low-grade fevers, and a bruise on her left inner shin. She denies any trauma that might have caused the bruise. She also denies nausea, vomiting, diarrhea, or other complaints. Clinical and physical examination Body temperature - 99.4 0 F Abdominal examination - Diffused mild tenderness Limbs – A single area of bruising on the right lower leg (Cover image).

Laboratory investigations Liver function tests - Elevated White blood cells - Normal Platelet count - 85 × 10 3 /uL Random blood glucose - 250 mg/dL Serum creatinine - 1.6 mg/dL. The patient was given an antacid but experienced minimal relief from abdominal pain. Which additional laboratory tests should you consider in…