5th June 2025

A 40-year-old woman presents with a 2 week history of malaise and increasing confusion, she is from the UK and has no significant past medical history, no history of recent travel and no sick contacts.

A 40-year-old woman presents with a 2 week history of malaise and increasing confusion, she is from the UK and has no significant past medical history, no history of recent travel and no sick contacts. In A&E she begins to develop right-sided upper and lower limb weakness. Blood tests show: WCC 9, Hb 70, platelets 15, reticulocytes 3 and CRP 20. A blood film shows schistocytes. Blood cultures are negative. She has also developed a rash on her lower limbs. What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.