Several reasons may explain the increase of both ADAMTS-13 testing and non-TTP TMAs during the study period: (1) a growing awareness among physicians of the existence of TMAs and ADAMTS-13 testing [30]; (2) a better and unrestricted access to the test due to its inclusion in the province's official directory of medical tests [31]; (3) the requirement for the treating physician to exclude a diagnosis of TTP—i.e. Here, ADAMTS13 is linked to thrombotic thrombocytopenic purpura.