!0 yo female presents with anemia (hb10), thrombocytopenia (plt 36) and acute renal failure (Cr 6.7mg/dl; BUN 117mg/dL), abdominal pain and confusion. The PB smear is shown as follows.
Increased schistocytes, microspherocytes and polychromasia; thrombocytopenia with increased proportion of large forms.