Cholangiocarcinoma presenting with acquired thrombotic thrombocytopenic purpura confirmed by positive autoantibodies of a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13

Schistocytes were found in her peripheral blood smear, and she had an elevated blood lactate dehydrogenase (LDH) level of 721 U/L and serum creatine level of 104 μmol/L (reference level: 45–84 μmol/L). Evidence showed that cytokines which inhibit ADAMTS13 activity, including interleukin-6, tumor necrosis factor-α, and interferon-γ, were increased in human tumor samples; a significant reduction of serum ADAMTS13 activity was also observed in tumor patients,[4] which might contribute to TTP onset. Dr. Lu Zhang, Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China E-Mail: pumczhanglu@126.com How to cite this article: