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Thrombotic Microangiopathic Syndrome as Presenting Manifestation of HIV

Abstract: Thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS) is a rare but well-described complication of advanced human immunodeficiency virus (HIV) infection. However, TTP-HUS had been rarely described as the presenting manifestation of HIV infection. We describe a case of a 45-year-old female who presented with classic manifestations of TTP-HUS and was subsequently found to have HIV. Patient responded to conventional treatment with plasma exchange. We conclude that clinicians need to have a high index of suspicion for retroviral infection when evaluating patients with TTP-HUS even when risk behaviors are not readily apparent.