ABSTRACT
Thrombotic thrombocytopenic purpura (TTP) is a severe multisystem thrombotic microangiopathy
(TMA). Significant advances have been made in understanding the pathogenesis of TTP
since the discovery of ADAMTS-13 (a disintegrin and metalloproteinase with thrombospondin-1-like domains), the enzyme that regulates the size of von Willebrand factor
(VWF) multimers. The inherited forms of TTP are mainly caused by a severe ADAMTS-13
deficiency, yet many aspects of the complex biological relationships between VWF-cleaving
metalloproteinase and acquired TMA are still unclear. This latter issue will be critically
addressed in this review article. In addition, the published literature evaluating
plasma ADAMTS-13 levels in other pathologic conditions different from TMA will also
be discussed.
KEYWORDS
ADAMTS-13 - von Willebrand factor - thrombotic microangiopathy
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Massimo FranchiniM.D.
Servizio di Immunoematologia e Trasfusione - Centro Emofilia, Azienda Ospedaliera
di Verona, P.le Stefani 1
37126 - Verona, Italy
Email: massimo.franchini@univr.it