Multiple studies have shown that systemic inflammation in the setting of sepsis, especially due to an infectious etiology, can result in acquired deficiency of ADAMTS13.68, –70 A study showed that platelets were markedly reduced in patients with ADAMTS13 activity <30% (39 000/μL) versus ADAMTS13 activity ≥ 30% (193 000/μL, P = .004). Here, ADAMTS13 is linked to hyperinsulinemic hypoglycemia, familial, 4.