Internal Medicine

0521779407-10 CUNY1086/Karliner 0 521 77940 7 June 6, 2007 17:44

866 Intravascular, Non-immune Hemolytic Anemia Iron Deficiency

complications and prognosis

Complications

■DIC

■bleeding, thrombosis, death

■TTP

■seizure, coma, stroke, paralysis, myocardial infarction, sudden death

■HUS

■hypertension, renal insufficiency, seizure, coma, death

Prognosis

■DIC

■depends primarily on initiating illness

■TTP

■almost universally fatal if left untreated

■80 to 90% of patients with primary TTP attain an initial remission;

one or more relapses occur in up to 40 % of patients at variable times

of weeks to years after initial event

■individuals with drug-induced or transplant-associated disease

appear less responsive to therapy

■HUS

■up to 60% of adult patients require dialysis; 50% develop chronic

renal insufficiency

■mortality up to 25% in adults

■epidemic cases have best prognosis

■sporadic cases, familial cases, older patients, patients without diar-

rhea and patients with severe renal dysfunction have poorer prog-

nosis

Iron Deficiency......................................

KENNETH R. BRIDGES, MD

history & physical

History

■Gastrointestinal bleeding

■colon cancer

■peptic ulcer disease

■esophageal or gastric varices

■Meckel’s diverticulum