Thrombotic Thrombocytopenic Purpura
A 40-year-old obese black woman has had weakness and epigastric pain for several weeks and diarrhea and vomiting for four days. She does not appear acutely ill; the physical examination is normal except for abdominal tenderness. Her hematocrit is 25 percent. The platelet count is 10,000 per cubic mi...
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| Veröffentlicht in: | The New England journal of medicine 2006-05, Vol.354 (18), p.1927-1935 |
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| container_end_page | 1935 |
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| container_issue | 18 |
| container_start_page | 1927 |
| container_title | The New England journal of medicine |
| container_volume | 354 |
| creator | George, James N |
| description | A 40-year-old obese black woman has had weakness and epigastric pain for several weeks and diarrhea and vomiting for four days. She does not appear acutely ill; the physical examination is normal except for abdominal tenderness. Her hematocrit is 25 percent. The platelet count is 10,000 per cubic millimeter. The peripheral-blood smear shows occasional fragmented and polychromatophilic red cells. The serum creatinine level is 1.1 mg per deciliter (97.2 μmol per liter), bilirubin 2.5 mg per deciliter (42.8 μmol per liter), and lactate dehydrogenase 722 U per liter (normal, |
| doi_str_mv | 10.1056/NEJMcp053024 |
| format | Article |
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A 40-year-old obese black woman has had weakness and epigastric pain for several weeks. The peripheral-blood smear shows occasional fragmented and polychromatophilic red cells. The serum creatinine level is 1.1 mg per deciliter, and lactate dehydrogenase 722 U per liter. How should this case be managed?
Foreword
This
Journal
feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.
Stage
A 40-year-old obese black woman has had weakness and epigastric pain for several weeks and diarrhea and vomiting for four days. She does not appear acutely ill; physical examination is normal except for abdominal tenderness. Her hematocrit is 25 percent. Her white-cell count and differential count are normal. The platelet count is 10,000 per cubic millimeter. The peripheral-blood smear shows occasional fragmented and polychromatophilic red cells. The serum creatinine level is 1.1 mg per deciliter (97.2 μmol per liter), bilirubin 2.5 mg per deciliter (42.8 μmol per liter), and lactate dehydrogenase 722 U per liter (normal, <250). How should . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJMcp053024</identifier><identifier>CODEN: NEJMAG</identifier><language>eng</language><publisher>Boston, MA: Massachusetts Medical Society</publisher><subject>Biological and medical sciences ; Children & youth ; Excretory system ; General aspects ; Hematologic and hematopoietic diseases ; Medical disorders ; Medical sciences ; Mortality ; Platelet diseases and coagulopathies</subject><ispartof>The New England journal of medicine, 2006-05, Vol.354 (18), p.1927-1935</ispartof><rights>Copyright © 2006 Massachusetts Medical Society. All rights reserved.</rights><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c360t-13baf35a610a7b4bfff2c56c13f1d07212dda9472017981d3a25da77bf098acd3</citedby><cites>FETCH-LOGICAL-c360t-13baf35a610a7b4bfff2c56c13f1d07212dda9472017981d3a25da77bf098acd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.nejm.org/doi/pdf/10.1056/NEJMcp053024$$EPDF$$P50$$Gmms$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/223935781?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,2757,2758,26101,27922,27923,52380,54062,64383,64387,72239</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17728763$$DView record in Pascal Francis$$Hfree_for_read</backlink></links><search><creatorcontrib>George, James N</creatorcontrib><title>Thrombotic Thrombocytopenic Purpura</title><title>The New England journal of medicine</title><description>A 40-year-old obese black woman has had weakness and epigastric pain for several weeks and diarrhea and vomiting for four days. She does not appear acutely ill; the physical examination is normal except for abdominal tenderness. Her hematocrit is 25 percent. The platelet count is 10,000 per cubic millimeter. The peripheral-blood smear shows occasional fragmented and polychromatophilic red cells. The serum creatinine level is 1.1 mg per deciliter (97.2 μmol per liter), bilirubin 2.5 mg per deciliter (42.8 μmol per liter), and lactate dehydrogenase 722 U per liter (normal, <250). How should this case be managed?
A 40-year-old obese black woman has had weakness and epigastric pain for several weeks. The peripheral-blood smear shows occasional fragmented and polychromatophilic red cells. The serum creatinine level is 1.1 mg per deciliter, and lactate dehydrogenase 722 U per liter. How should this case be managed?
Foreword
This
Journal
feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.
Stage
A 40-year-old obese black woman has had weakness and epigastric pain for several weeks and diarrhea and vomiting for four days. She does not appear acutely ill; physical examination is normal except for abdominal tenderness. Her hematocrit is 25 percent. Her white-cell count and differential count are normal. The platelet count is 10,000 per cubic millimeter. The peripheral-blood smear shows occasional fragmented and polychromatophilic red cells. The serum creatinine level is 1.1 mg per deciliter (97.2 μmol per liter), bilirubin 2.5 mg per deciliter (42.8 μmol per liter), and lactate dehydrogenase 722 U per liter (normal, <250). How should . . .</description><subject>Biological and medical sciences</subject><subject>Children & youth</subject><subject>Excretory system</subject><subject>General aspects</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Medical disorders</subject><subject>Medical sciences</subject><subject>Mortality</subject><subject>Platelet diseases and 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N</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c360t-13baf35a610a7b4bfff2c56c13f1d07212dda9472017981d3a25da77bf098acd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Biological and medical sciences</topic><topic>Children & youth</topic><topic>Excretory system</topic><topic>General aspects</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Medical disorders</topic><topic>Medical sciences</topic><topic>Mortality</topic><topic>Platelet diseases and coagulopathies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>George, James N</creatorcontrib><collection>Pascal-Francis</collection><collection>CrossRef</collection><collection>Pharma and Biotech Premium PRO</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central 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medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>George, James N</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thrombotic Thrombocytopenic Purpura</atitle><jtitle>The New England journal of medicine</jtitle><date>2006-05-04</date><risdate>2006</risdate><volume>354</volume><issue>18</issue><spage>1927</spage><epage>1935</epage><pages>1927-1935</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><coden>NEJMAG</coden><abstract>A 40-year-old obese black woman has had weakness and epigastric pain for several weeks and diarrhea and vomiting for four days. She does not appear acutely ill; the physical examination is normal except for abdominal tenderness. Her hematocrit is 25 percent. The platelet count is 10,000 per cubic millimeter. The peripheral-blood smear shows occasional fragmented and polychromatophilic red cells. The serum creatinine level is 1.1 mg per deciliter (97.2 μmol per liter), bilirubin 2.5 mg per deciliter (42.8 μmol per liter), and lactate dehydrogenase 722 U per liter (normal, <250). How should this case be managed?
A 40-year-old obese black woman has had weakness and epigastric pain for several weeks. The peripheral-blood smear shows occasional fragmented and polychromatophilic red cells. The serum creatinine level is 1.1 mg per deciliter, and lactate dehydrogenase 722 U per liter. How should this case be managed?
Foreword
This
Journal
feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.
Stage
A 40-year-old obese black woman has had weakness and epigastric pain for several weeks and diarrhea and vomiting for four days. She does not appear acutely ill; physical examination is normal except for abdominal tenderness. Her hematocrit is 25 percent. Her white-cell count and differential count are normal. The platelet count is 10,000 per cubic millimeter. The peripheral-blood smear shows occasional fragmented and polychromatophilic red cells. The serum creatinine level is 1.1 mg per deciliter (97.2 μmol per liter), bilirubin 2.5 mg per deciliter (42.8 μmol per liter), and lactate dehydrogenase 722 U per liter (normal, <250). How should . . .</abstract><cop>Boston, MA</cop><pub>Massachusetts Medical Society</pub><doi>10.1056/NEJMcp053024</doi><tpages>9</tpages></addata></record> |
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| ispartof | The New England journal of medicine, 2006-05, Vol.354 (18), p.1927-1935 |
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| language | eng |
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| source | EZB-FREE-00999 freely available EZB journals; ProQuest Central UK/Ireland; New England Journal of Medicine |
| subjects | Biological and medical sciences Children & youth Excretory system General aspects Hematologic and hematopoietic diseases Medical disorders Medical sciences Mortality Platelet diseases and coagulopathies |
| title | Thrombotic Thrombocytopenic Purpura |
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