A 43-year-old male with hypertension and diabetes mellitus (DM), complicated by nephropathy and retinopathy, underwent a pre-emptive living-related renal transplant by a donation from his 33-year-old wife. His immediate post-transplant period was unremarkable. Eight months after the transplant, while the patient was maintained on steroids, CellCept and tacrolimus, his platelet count dipped to 13,000/microL, and he had an episode of mild epistaxis. An extensive workup revealed no clinical or laboratory evidence of unusual substance intake, infection, haemolysis, microangiopathy, autoimmune disease or haematological malignancy.
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