He was empirically managed for thrombotic thrombocytopenic purpura (TTP) but, after lack of improvement and normal ADAMTS13 (a disintegrin and metalloproteinase with thrombospondin type 1 motif, 13) level, was eventually diagnosed with mCSPC with BM involvement. Here, ADAMTS13 is linked to thrombotic thrombocytopenic purpura.