Skip to main content
. Author manuscript; available in PMC: 2024 May 26.
Published in final edited form as: N Engl J Med. 2024 May 9;390(18):1690–1698. doi: 10.1056/NEJMoa2402567

Figure 1. Clinical Features of Severe Refractory iTTP.

Figure 1.

Panel A shows the peripheral smear taken on day 0 (50X magnification) after application of a computerized algorithm for the automated detection of schistocytes (blue shaded cells). The patient’s heart rate trend (Panel B) and subcostal view on a transthoracic echocardiogram performed on day 14 (Panel C) reflect progressive pericardial tamponade, including a large circumferential pericardial effusion (red arrow) and evidence of right ventricular diastolic inversion (red arrowhead). The patient’s heart rate declined immediately following pericardiocentesis (Panel B, blue arrow). Pathologic examination of the pericardium is depicted in Panel D. At 40X magnification (left), there is fibrin on the surface of the pericardium (arrowheads). At 200X magnification (right), the fibrin (asterisks) is being organized by mononuclear cells (arrows).