The acquired ADAMTS13 deficiency in such settings can exacerbate the levels of ULVWF multimers that may already be increased from EA-VMTD and TTP-like syndrome in ARDS and MODS.56,70 Decreased ADAMTS13 levels correlate with progression to multi-organ failure and, along with appearance of ULVWF multimers in plasma, have been associated with an increased risk of mortality in patients with sepsis.69,70. The gene discussed is ADAMTS13; the disease is acute respiratory distress syndrome.