A 23-year-old woman presented with abdominal pain and blurred vision in both eyes. Fundoscopy revealed large bullous detachments of her neurosensory retina with shifting subretinal fluids bilaterally. Laboratory studies showed a hemoglobin of 6.5 mmol/l, thrombocytes 20 x 10 9/l, and LDH 1098 U/l. A peripheral blood smear revealed red blood cell fragmentation. A diagnosis of thrombotic thrombocytopenic purpura was made. The patient was treated with four sessions of plasmapheresis followed by plasma infusions, which resulted in a complete recovery. (C) 2000 Elsevier Science B.V.