| Summary points: | A previously healthy 36-year-old woman presents to hospital peri-arrest with hypertension, sustained loss of consciousness following a tonic-clonic seizure, and micropathic haemolytic anaemia on blood film. Medical history, clinical examination, autoimmune studies, CT, chest x-ray, and echocardiogram are described; image provided. The authors review microangiopathic haemolytic anaemia and scleroderma renal crisis and discuss the importance of re-examination, especially in the critically injured, in conjunction with unusual laboratory test findings. |