{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T10:41:03Z","timestamp":1687344063319},"reference-count":20,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T00:00:00Z","timestamp":1605139200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_almed-2020-0082_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The objective of this study was to highlight the role of the clinical laboratory and the relevance of reporting the case immediately to the unit of hematology for the diagnosis and early administration of treatment in the presence of such an urgent hematologic disease as thrombotic thrombocytopenic purpura (TTP).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_almed-2020-0082_abs_002\">\n                  <jats:title>Case presentation<\/jats:title>\n                  <jats:p>An elderly patient was referred to the emergency department of our hospital by his general practitioner for speech difficulty, facial asymmetry and weakness in the upper limb. Stroke code was activated. However, laboratory findings (anemia, thrombocytopenia, elevated creatinine, total bilirubin and LDH, negative direct Coombs test) and presence of schistocytes in the peripheral blood smear test were consistent with a completely different diagnosis: TTP thrombotic microangiopathy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_almed-2020-0082_abs_003\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The first diagnostic approach of left hemispheric stroke was not confirmed in the laboratory, with findings of nonautoimmune hemolytic anemia, thrombocytopenia without apparent cause and presence of schistocytes. We should not forget that the clinical manifestations of this condition are widely variable and may include multiorganic dysfunction. Although confirmation of diagnosis is based on ADAMTS-13, its associated high mortalitiy requires immediate treatment on mere suspicion.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/almed-2020-0082","type":"journal-article","created":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T08:01:13Z","timestamp":1605600073000},"page":"129-132","source":"Crossref","is-referenced-by-count":0,"title":["Fluctuating neurological symptoms: should I call the neurologist or the hematologist?"],"prefix":"10.1515","volume":"2","author":[{"given":"Rita","family":"Losa-Rodr\u00edguez","sequence":"first","affiliation":[{"name":"Service of Laboratory Analysis , Hospital Cl\u00ednico Universitario de Valladolid , Valladolid , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"P\u00e9rez Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda y Hemoterapia , Hospital Cl\u00ednico Universitario de Valladolid , Valladolid , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Rodr\u00edguez P\u00e9rez","sequence":"additional","affiliation":[{"name":"Service of Laboratory Analysis , Hospital Cl\u00ednico Universitario de Valladolid , Valladolid , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ignacio","family":"de la Fuente Graciani","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda y Hemoterapia , Hospital Cl\u00ednico Universitario de Valladolid , Valladolid , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara M.","family":"G\u00f3mez Garc\u00eda","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda y Hemoterapia , Hospital Cl\u00ednico Universitario de Valladolid , Valladolid , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2020,11,12]]},"reference":[{"key":"2023062110033102346_j_almed-2020-0082_ref_001","doi-asserted-by":"crossref","unstructured":"Kremer Hovinga, JA, Coppo, P, L\u00e4mmle, B, Moake, JL, Miyata, T, Vanhoorelbeke, K. Thrombotic thrombocytopenic purpura. Nat Rev Dis Prim 2017;6:17020. https:\/\/doi.org\/10.1038\/nrdp.2017.20.","DOI":"10.1038\/nrdp.2017.20"},{"key":"2023062110033102346_j_almed-2020-0082_ref_002","doi-asserted-by":"crossref","unstructured":"Amorosi, EL, Ultmann, JE. Thrombotic thrombocytopenic purpura: report of 16 cases and review of the literature. Medicine 1966;45:139\u201359. https:\/\/doi.org\/10.1097\/00005792-196603000-00003.","DOI":"10.1097\/00005792-196603000-00003"},{"key":"2023062110033102346_j_almed-2020-0082_ref_003","doi-asserted-by":"crossref","unstructured":"Moake, JL, Turner, NA, Stathopoulos, NA, Nolasco, LH, Hellums, JD. Involvement of large plasma von Willebrand Factor (vWF) multimers and unusually large vWF forms derived from endothelial cells in shear stress-induced platelet aggregation. 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