ADAMTS13 and infection: cTTP episodes are often triggered by physiological stressors and have a bimodal age of presentation.<h4>Objectives</h4>To summarize the clinical course, complications, and advances in treatment of cTTP, highlighting the role of recombinant ADAMTS-13 (rADAMTS-13).<h4>Methods</h4>A review of registry data, clinical studies, and expert guidelines was conducted to assess cTTP pathophysiology, presentation, and therapeutic approaches.<h4>Results</h4>Acute cTTP episodes manifest variably, often requiring a "second hit," such as infection or pregnancy, for disease induction.