A 31-year-old woman has presented to the emergency department with significant bruising on her arms and legs that have been getting worse. History: Five days ago, her bruises were smaller. She visited GP but noticed they were becoming larger and more widespread. She has had no fevers, arthralgia or recent viral infections, and she is not taking any medications. Physical examination: A marked petechial rash over her legs with large bruising on the arms and legs.
A cardiovascular and respiratory exam is normal. On abdominal examination, there is no hepatosplenomegaly and there is no lymphadenopathy. Observations: temperature 36.8°C, heart rate 78/min, blood pressure 135/67 mmHg, respiratory rate 18/min, SaO2 98 percent on air. Investigations: WBC: 6.0 billion/L(No abnormal WBCs), platelets 15 billion/L Hb 11.1 g/dL Na 133 mmol/L, K 6.7 mmol/L, Urea 5.4 mmol/L, Creatinine 65 mmol/L What is…
