Clinical features + heme labs with red blood cell fragments or schistocytes.
May have bleeding and thrombosis
Signs and symptoms of anemia (fatigue, pallor, palpitations, etc.)
Jaundice and scleral icterus
Signs/symptoms of underlying disease process
Microangiopathic hemolytic anemia
Disseminated Intravascular Coagulation 
Autoimmune hemolytic anemia
Thrombotic Thrombocytopenic Purpura 
Polycythemia vera
Hemolytic Uremic Syndrome 
Aplastic anemia
HELLP syndrome