MKSAP: 35-year-old woman with new-onset thrombocytopenia
A 35-year-old woman is evaluated for new-onset thrombocytopenia. She is gravida 1 at 36 weeks’ gestation. Her pregnancy has been otherwise uncomplicated. She takes only a prenatal vitamin.
On physical examination, temperature is normal, blood pressure is 110/65 mm Hg, pulse rate is 110/min, and respiration rate is 22/min. There are no ecchymoses or petechiae. Abdominal examination discloses no right upper quadrant pain. She has a gravid uterus. Neurologic examination is normal, and there is no peripheral edema.
Laboratory studies:
Hematocrit
33%
Hemoglobin
11.0 g/dL (110 g/L)
Leukocyte count
9500/µL (9.5 × 109/L)
Mean corpuscular volume
85 fL
Platelet count
95,000/µL (95 × 109/L)
Fibrinogen
350 mg/dL (3.5 g/dL)
Alanine aminotransferase
Normal
Aspartate aminotransferase
Normal
Urinalysis
Normal
No schistocytes or platelet clumping is seen on the peripheral blood smear.
Which of the following is the most appropriate management?
A: Corticosteroids
B: Emergent delivery of fetus
C: Intravenous immune globulin
D: Plasma exchange
E: Repeat complete blood count in 1 to 2 weeks
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Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: mksap Tags: Conditions OB/GYN Source Type: blogs
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