Chikungunya Fever Presenting as Life Threatening Thrombotic Thrombocytopenic Purpura.

It is well known for Chikungunya fever to present as myriad of skin rash along with usual joint pain and fever, but probably this is the first case report of Chikungunya fever presenting as severe life threatening thrombotic microangiopathy, thrombotic thrombocytopenic purpura leading to multiple areas of skin necrosis, peripheral digital gangrene, haemolytic anemia, renal failure and severe thrombocytopenia with bleeding. This complication was most likely due to inhibitor autoantibody formation against ADAMTS13 triggered by chikungunya virus leading to thrombotic thrombocytopenic purpura. Patient was treated with plasmapheresis and other supportive careto which she responded. Her symptoms subsided, and she is symptom free and leading normal life in her follow up visits.