Case 33-1994

Presentation of CaseA 41-year-old woman was transferred to this hospital because of thrombocytopenia, anemia, and changed mental status.There was a history of treated hypothyroidism, well-controlled hypertension, and mild anemia of several years' duration accompanied by slight leukopenia. Hematologic studies were performed seven months before admission (Table 1). A test for antinuclear antibodies, performed 11 months before admission, was negative. The patient was otherwise well until five days before admission, when she was admitted to another hospital because of one week of substernal pain that radiated to the left hand, tingling in the right leg, intermittent headaches, and light . . .