A 21-year-old male presented to the emergency department after a 5-day history 
of recurrent vomiting and decreased urine output. History revealed ingestion of 
ibuprofen. During the diagnostic workup, the following was identified: white 
blood cell count 13.4 (×10(3)/mcL), hemoglobin 11.9 (×10(6)/mcL) with an MCV of 
73 fL, hematocrit 34% and platelets were 31,000/mcL, sodium of 130 mmol/L, 
potassium of 5.1 mmol/L, chloride of 83 mmol/L, bicarbonate of 21 mmol/L, blood 
urea nitrogen of 184 mg/dL and creatinine of 19.1 mg/dL. He was later diagnosed 
with thrombotic thrombocytopenic purpura (TTP) based on the fact that he 
presented with most components of the TTP pentad (except for fever), which 
included altered mental status, acute kidney injury, thrombocytopenia, and 
evidence of red cell fragmentation and his ADAMTS13 level was found to be less 
than 10% prior to therapy. The patient then received plasma exchange, oral 
corticosteroids, and hemodialysis, which led to a full recovery of platelet 
count and renal function.