Thrombotic thrombocytopenic purpura without anemia

A patient is described who presented with fever, fluctuating neurological abnormalities, renal dysfunction, and thrombocytopenia. The necropsy revealed the classic histological findings of thrombotic thrombocytopenic purpura (TTP). Hemolytic anemia and fragmented red cells, hallmarks of TTP, were absent in our patient; this does not fit into the classic description of this syndrome.