eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2020-12-30 9 3 147 149 10.12691/ajmcr-9-3-3 AJMCR2021933 article Eman EL-Sawalhy Eman.elsawalhy@beaumont.org 1 Hammam Shereef 2 Hana Manzoor 2 Fadi Abuhmaid 3 Shahina Patel 4 Department of Internal Medicine, Beaumont Hospital, Dearborn, MI Department of Internal Medicine, Beaumont Health-Dearborn, 18101 Oakwood Blvd. Dearborn, MI Division of Nephrology, Internal Medicine Department, Beaumont Hospital, Dearborn, MI Division of Hematology & Oncology, Internal Medicine Department, Beaumont Hospital, Dearborn, MI Since COVID-19 has been declared a global pandemic, variable clinical presentations have been reported, most commonly with respiratory symptoms and less commonly gastrointestinal or neurological symptoms. Hematologic disorders in the form of thrombotic microangiopathies (TMA) such as immune thrombocytopenic purpura (ITP), thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), and microangiopathic hemolytic anemia (MAHA) were also linked to the COVID-19 positive population. Many studies have proposed several possible theories, including viral-mediated, endothelial related, immune triggered, and consumptive mechanisms. In most of the literature, the severity of the disease is associated with more severe thrombocytopenia, with lower levels being associated with higher mortality. We herein report a case of a patient who tested positive for COVID-19 and went on to develop severe thrombocytopenia. Workup of the thrombocytopenia revealed that he had developed acquired Thrombotic thrombocytopenic purpura (TTP). Our case report highlights the need for early recognition, prompt diagnosis, and the subsequent initiation of urgent treatment. http://pubs.sciepub.com/ajmcr/9/3/3/ajmcr-9-3-3.pdf COVID-19 TTP