In addition, consumption of ADAMTS13 due to excess of its substrate, VWF, or excess of plasmin, has been observed in sepsis, disseminated intravascular coagulopathies (DICs), and thrombotic microangiopathy (TMA).23, 24, 25, 26, 27Indeed, elevated VWF antigen and activity levels, D-dimer levels, FM levels along with moderately reduced ADAMTS13 activity levels is a repertoire of hallmarks shared by critical illnesses that result in severe microvascular endothelial cell injuries.28, 29, 30. The gene discussed is ADAMTS13; the disease is thrombotic microangiopathy.