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1st June 2023
A 45-year-old woman attends her local A&E department complaining of a few days’ history of severe epistaxis and haematemesis
A 45-year-old woman attends her local A&E department complaining of a few days’ history of severe epistaxis and haematemesis. Her partner mentions she is more confused than normal. Examination reveals jaundiced sclera, pallor and she is confused. Her temperature is 38.5, BP is 104/67 and HR is 109.
She is normally fit and well, with no other medical conditions.
Blood tests are performed:
| Hb | 82g/L | Females: (115 – 155 g/L) |
| Platelets | 13 x 10⁹/L | (150 – 400 x 10⁹/L) |
| WCC | 8.2 x 10⁹/L | (4 – 11 x 10⁹/L) |
| Na+ | 152 mmol/L | (135 – 145 mmol/L) |
| K+ | 5.0 mmol/L | (3.5 – 5.0 mmol/L) |
| Urea | 15.3 mmol/L | (2.5 – 6.5 mmol/L) |
| Creatinine | 184 μmol/L | (50 – 120 μmol/L) |
| Bilirubin | 62 mg/L | (2 – 17 µmol/L) |
| Haptoglobin | 0.2 g/L | Female: (0.4 – 1.6 g/L) |
| LDH | 640 IU/L | (100 – 190 IU/L) |
| Blood film | Thrombocytopenia and fragmented RBCs | |
Given the likely diagnosis, what is the main treatment for this condition?
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