A delay in diagnosis: thrombotic thrombocytopenia purpura occurring in systemic lupus erythematous

Adam Mabrouk, Aga Khan University
Ahmed Sokwala, Aga Khan University
Jasmit Shah, Aga Khan University
Sayed Karar, Aga Khan University


Thrombotic thrombocytopenia purpura (TTP) in the background of systemic lupus erythematous (SLE) remains rare with an incidence of about 2%. Both conditions have overlapping features and can thus be difficult to differentiate and diagnose. A careful review of the peripheral blood smear remain essential often providing many clues. The diagnosis of TTP is a medical emergency and therapy should be instituted immediately. We present one such challenging case where a delay in diagnosis due to limited resources could have proven fatal for our patient.