Thromobotic thrombocytopenic purpura (TTP) is a multisystem disorder that's characterized by consumptive thrombocytopenia, microangiopathic hemolytic anemia,and neurologic symptoms. TTP is associated with many diseases and several therapeutic drugs. We report here on the first Korean case of a patient with rheumatoid arthritis (RA) and who developed TTP that was associated with trimethoprim-sulfamethoxazole (TMP-SMX) in Korea. She recovered from the TTP following daily sessions of therapeutic plasma exchange (TPE) with fresh plasma replacement and glucocorticoid therapy. Awareness of the possible development of TTP in patient with RA and who is being treated with TMP-SMX is important for making the early diagnosis and administering proper treatment.

Keywords: Thrombotic thrombocytopenic purpura, Rheumatoid arthritis, Trimethoprim- Sulfamethoxazole, Therapeutic plasma exchange, Glucocorticoid