THBD and thrombotic thrombocytopenic purpura: Recombinant thrombomodulin (rTM) is an anticoagulant that is used to treat DIC and expected to alleviate vascular endothelial dysfunction.[14] Therefore, theoretically, rTM may be effective as a treatment for TTP.[15,16] We previously described the successful remission of secondary TTP by rTM monotherapy.[17] Since rTM causes fewer adverse reactions without invasiveness and immunosuppression, unlike existing TTP treatments, it may serve as a therapeutic drug for TTP.