Recombinant ADAMTS13 (rADAMTS13) as rescue therapy for acute cTTP during pregnancy. The patient’s clinical course and treatment are illustrated. Her home dose of Koate was intensified twice daily on days 0 and 1 of the presentation. Given the lack of a response, rADAMTS13 was initiated on day 2. Platelets (blue) and LDH (orange) normalized rapidly. ADAMTS13 activity levels obtained at various time points are shown in blue boxes. Induction of labor commenced on day 5, with successful delivery on day 6. She remains on prophylactic therapy with rADAMTS13. LDH, lactate dehydrogenase.