This definition appears rarely
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In addition, the absence of fever and the patient's normal platelet count reduce the likelihood of TTP. There are several case reports of ciprofloxacin-induced hemolysis , but our patient had already developed anemia and hemoglobinuria suggestive of ongoing hemolysis before being started on ciprofloxacin in the emergency room. Another possibility is Evans syndrome, which is a DAT-positive hemolytic anemia and immune thrombocytopenia with no known underlying etiology. Evans syndrome causes chronic hemolytic anemia, which our patient did not have, and it is rarely fulminant. A third possibility is hemolytic anemia associated with acute hepatitis.