SIMILARITIES IN THE PRESENTATION OF SEVERE MALARIA AND THROMBOTIC THROMBOCYTOPENIC PURPURA: A CASE REPORT FROM A RURAL KENYAN HOSPITAL

Severe malaria can present with clinical features strikingly similar to those of thrombotic thrombocytopenic purpura (TTP), including the “pentad” of fever, microangiopathic hemolytic anemia, severe thrombocytopenia, neurological deficits, and renal failure. This finding is believed to be due to a shared pathogenetic pathway involving thrombotic microangiopathy, resulting in increased von Willebrand factor levels and decreased ADAMTS13 activity. In this study, we present the case of a 56-year-old Kenyan woman who presented with the “TTP pentad,” jaundice, hypoglycemia, shock, and repeatedly negative thin blood slide microscopy results for malaria, but her peripheral blood film revealed numerous Plasmodium falciparum malaria parasites. The patient was treated with intravenous artesunate and artemether-lumefantrine, as well as supportive care, with complete resolution of her symptoms and normalization of her laboratory derangements. We emphasize awareness of this shared pathogenesis and a high index of suspicion for either disease in appropriate clinical contexts to minimize delays in providing life-saving treatment