Decreased platelet count, increased bleeding time. Decreased platelet survival. Could be due to deficiency of ADAMTS13 (vWF metalloprotease), which leads to decreased degradation of vWF multimers-->large vWF multimers-->platelet aggregation, thrombosis, platelets are consumed-->microthrombi circulate and hemolyze RBCs as they circulate. Labs should show schistocytes and increased LDH. PENTAD: neurologic and renal symptoms, fever, thrombocytopenia, microangiopathic hemolytic anemia. Can also be secondary to cancer, pregnancy, quinine, clopidogrel, HIV, immunosuppressants. Decreased platelet count, increased bleeding time, PT, and PTT, decreased fibrinogen, decreased factors V and VIII, increased D-dimers (fibrin split products), schistocytes. Widespred activation of clotting factors-->decreased clotting factors-->bleeding. Can be caused by sepsis, trauma, obstetric complications, acute pancreatitis, malignancy, nephrotic syndrome, transfusion.