To Consider the Diagnosis of TTP in cases of Thrombocytopenia Presenting to Er with altered mental status. A 28 year young male known case of seizure Disorder Juvenile Myoclonic Epilepsy Presenting to Er with complaints of sudden onset of altered mental status since 1 day with history of fever for 1 day Documented 3 days back and his labs revealed thrombocytopenia with Aki. Patient was initially managed conservatively with Antiepileptics, IV fluids, Antibiotics and supportive therapy. In course of hospital stay, patient developed Hemolysis with generalised tonic clonic seizures and was later diagnosed as TTP (Sepsis Induced) with Neurological Involvement with AKI with status epilepticus.

A case of thrombocytopenia with altered mental status presenting in Er, A Differential Diagnossis of TTP must be considered in Initial Period.