Snapshot A 21-year-old woman with past medical history of SLE presents with fever, fatigue, and altered mental status. On physical exam, a petechial rash is seen on her upper extremities. Her temperature is 103°F (39.4°C). Her labs are notable for Hgb 7.3 g/dL, platelets 17,000/mm3, and creatinine of 3.4 mg/dL. Introduction Thrombotic microangiopathy characterized by a pentad login to view 5 more bullets Similar to HUS but with fever and neurologic symptoms Epidemiology login to view 2 more bullets Pathogenesis login to view 8 more bullets Presentation Symptoms (recall pentad) login to view 8 more bullets Physical exam login to view 5 more bullets Evaluation Complete blood count login to view 2 more bullets Peripheral blood smear login to view 1 more bullet Serum login to view 3 more bullets ↑ bleeding time normal PT/PTT Differential Diagnosis DIC HUS Sepsis Treatment Plasma exchange transfusion with fresh frozen plasma Steroids Splenectomy Platelet transfusion contraindicated login to view 1 more bullet Prognosis, Prevention, and Complications Prognosis login to view 2 more bullets Complications login to view 1 more bullet