Thrombotic thrombocytopenic purpura (TTP) consists of the pentad of 
thrombocytopenia, hemolytic anemia, fever, neurologic abnormalities, and renal 
disease. We present a case report of acute TTP following a bout of ischemic 
colitis. This report reminds the clinician that ischemic colitis can be an 
atypical presentation of TTP. The prompt recognition and treatment of this 
disease process resulted in a good prognosis for our patient.