Patient History: A 23-year-old man, presented to the physician with a long medical history of easy bruising. In addition, he has had several instances of severe bruising following minor trauma and progressively worsening arthritis of both knee joints over the past four years. Three months ago, he noted the appearance of silver-dollar-sized purple blotches on his skin that have still not gone away. In the past week, he has progressively weakened, suffering from chills, weakness, and a high fever that has left him bedridden.
Family History: Interestingly, his maternal grandfather died at age 27 of a bleeding complication following an appendectomy. His maternal grandmother remarried, and his mother lost complete touch with her deceased father's family. His mother's three half-brothers are alive and well. Laboratory studies reveal a white blood cell count of 2.8 (2,800 WBCs per mm 3 ;…
