A 68-year-old woman came with the complaint of spontaneous bruising mainly on her legs. History: Noticeable bruising over the last 3 weeks. Suffered from a major nosebleed. Feels very tired and has noticed shortness of breath on exertion. Non-smoker and drinks a small amount of alcohol socially. On examination, Multiple areas of purpura (from black–purple to yellow in colour) on her legs and to a lesser extent on her abdomen and arms. She was pale with conjunctival pallor.
Two bullae in the mouth, spontaneous bleeding from the gums. On fundoscopy, multiple small retinal haemorrhages observed. Blood pressure is 118/72 mmHg. What is the differential diagnosis? How would you further investigate and manage this patient? Source: Cases in Clinical Medicine *This case is from Docplexus editorial team for educative purpose only.
