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The first three symptoms frequently occur together (50�C75%), but all five symptoms rarely occur at the same time, and therefore the pentad is considered to be [http://www.selleckchem.com/products/gsk2656157.html GSK2656157] out-dated [7], [8]?and?[9]. George and colleagues showed that among eighteen patients diagnosed with TTP, and an ADAMTS13 level of [http://en.wikipedia.org/wiki/17-Dimethylaminoethylamino-17-demethoxygeldanamycin 17-DMAG (Alvespimycin) HCl] in ultra-large VWF-multimers that cause platelet aggregation, thrombocytopenia and Coombs-negative haemolysis (TMA). A plasma ADAMTS13 activity level of [http://www.selleckchem.com/products/i-bet151-gsk1210151a.html Epigenetics inhibitor] Hulstein and colleagues found a significant decreased ADAMTS13 in patients diagnosed with HELLP syndrome (n?=?14) when compared with patients with a normal pregnancy (n?=?9) [14]. Other studies show that ADAMTS13 activity between 10 and 50% is compatible with a near term of normal pregnancy and that from week twelve of gestation there is a significant decrease in activity compared to non-pregnant women [9]?and?[12]. Schistocytes are fragmented erythrocytes that are injured by damaged endothelium [11]. It is important to use a threshold of 0.2�C0.5% for schistocytes before suspecting TTP.