von Willebrand Factor–Cleaving Protease in Thrombotic Thrombocytopenic Purpura and the Hemolytic–Uremic Syndrome

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Abstract
The study by Furlan et al. (Nov. 26 issue)1 provides evidence of an inhibitor of von Willebrand factor–cleaving protease in the pathogenesis of thrombotic thrombocytopenic purpura but not of the hemolytic–uremic syndrome. In this study, patients were classified as having either syndrome without knowledge of the results of the von Willebrand factor–cleaving protease assay. However, the authors did not describe the criteria by which the diagnosis was made. In addition, some of the distinguishing characteristics, such as disease chronicity and the likelihood of relapse, could only have been determined retrospectively.