Thrombotic Thrombocytopenic Purpura in a 33-Year-Old Female Presenting to a Rural Emergency Department: A Case Report

Thrombotic thrombocytopenic purpura is a rare, life-threatening hematologic emergency characterized by thrombocytopenia, microangiopathic hemolytic anemia, renal dysfunction, neurologic symptoms, and fever. Prompt recognition and treatment are crucial for improving outcomes.

A 33-year-old female presented to a rural emergency department with fever, malaise, cognitive changes, and pancytopenia. Initial evaluation revealed severe thrombocytopenia and anemia, raising suspicion for thrombotic thrombocytopenic purpura.

The patient was stabilized with intravenous fluids and transferred to a tertiary hospital, where she was confirmed to have thrombotic thrombocytopenic purpura based on ADAMTS13 deficiency. She received plasma exchange and corticosteroid therapy, followed by outpatient hematology follow-up.

This case underscores the importance of early recognition of thrombotic thrombocytopenic purpura, particularly in rural and resource-limited settings, where delays in transfer and specialized care can significantly increase mortality risk. Emergency nurses play a pivotal role in identifying clinical red flags, initiating stabilization, and coordinating timely transfer.