A 45-year-old man suffers severe third-degree burns in an industrial accident. During his hospital stay, the patient develops anemia, thrombocytopenia, and widespread purpura. Blood oozes from venipuncture sites. Laboratory studies show that fibrin split products are elevated. The peripheral blood smear is shown in the image. What is the appropriate diagnosis?
Idiopathic thrombocytopenic purpura
Microangiopathic hemolytic anemia
Answer : D Microangiopathic hemolytic anemia
Microangiopathic hemolytic anemia results from abnormalities in the microcirculation that causes turbulent blood flow patterns. The classic examples of this type of hemolytic anemia are DIC and TTP; both of which feature generalized thrombosis of capillary vessels.
Long-distance running or walking or prolonged vigorous exercise can cause repetitive trauma to red blood cells in the microcirculation leading to hemolysis. Alterations in blood flow, as are encountered in malignant hypertension or vasculitis syndromes, may also produce mechanical fragmentation of erythrocytes. Microangiopathic features are not observed in the other choices.