Correct!
1. ADAMTS-13

A test for ADAMTS-13 was ordered with a very low level confirming TTP (4-7). ADAMTS13 is an enzyme primarily synthesized in the liver. Its main function is to cleave von Willebrand factor anchored on the endothelial surface. While the test was pending, the patient was started on corticosteroids with no significant clinical response appreciated. The diagnosis of TTP was confirmed when a very low ADAMTS-13 level was reported. 

For TTP patients clinically unresponsive to corticosteroids, what alternative therapies can be used? (click on the correct answer to be directed to the eighth and final page)

1. Plasma exchange
2. Rituximab
3. Vincristine
4. 1 and 3
5. All of the above

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