Acute thrombotic thrombocytopenic purpura presenting as expressive aphasia

Thrombotic thrombocytopenic purpura (TTP) is an uncommon and potentially fatal disease that is characterized by endothelial cell abnormalities, platelet dysfunction, microangiopathic hemolysis, fever, neurological abnormalities, and renal involvement. Before the introduction of plasmapharesis in the 1970s, TTP was fatal. This case report is presented to illustrate how subtly TTP can present, to discuss the updated criteria for TTP diagnosis, and to emphasize that with effective treatment now available, accurate and early diagnosis is essential to decrease morbidity and mortality.