Although many cases are idiopathic, TTP may be secondary to cancer, drugs as quinine [3], ticlopidine [11], clopidogrel [12], chemotherapeutic agents as mitomycin C, gemcitabine, immunosuppressant agents cyclosporine A, tacrolimus [13], valacyclovir [14], congenital ADAMTS-13 deficiency, acute inflammatory states such as pancreatitis or HIV infection [3], and it has also been described in pregnancy and allogeneic hematopoietic stem cell transplant patients [15]. Here, ADAMTS13 is linked to hyperinsulinemic hypoglycemia, familial, 4.