Symptoms that could indicate a possible exacerbation or relapse of thrombotic thrombocytopenic purpura (TTP)

For a patient with a history of TTP, these symptoms should not be attributed to a viral illness or other cause. Any of these symptoms should prompt immediate (same day) CBC with platelet count, and if thrombocytopenia is present, the patient should be admitted to the hospital for further evaluation and possible immediate treatment, including therapeutic plasma exchange (TPE). Clinicians should not adopt a "watch and wait" approach for a patient with a history of TTP who has these symptoms.