A 49-year-old woman presents with upper abdominal pain, intermittent nausea and vomiting, malaise, and night sweats for 3 weeks, in association with a 6 kg weight loss. She also experienced easy bruising during the same period. There was no history of epistaxis, hematemesis, melena, or other bleeding manifestations. Her medical, surgical, and drug histories are unremarkable. There is no family history of bleeding disorders. She does not smoke, drink or use recreational drugs. Her ESR is 31 mm/1h.