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Compared with TTP, cases with malignant hypertension-induced TMA are shown to have higher blood pressure at presentation, signs of hypertensive heart disease [van den Born et al. 2005] or retinopathy, higher platelet count [Shibagaki and Fujita, 2005; Shavit et al. 2010] and higher ADAMTS-13 activity [van den Born et al. 2008]. Patients with malignant hypertension, compared with healthy controls, can have lower levels of ADAMTS-13; the levels negatively correlated with LDH levels, platelet count and the presence of schistocytes. However, the deficiency of ADAMTS-13 is always mild (activity >50%) [van den Born et al. 2008]. In the Oklahoma TTP Registry, none of the patients with malignant hypertension-induced TMA had ADAMTS-13 activity failure. Aggressive management of blood pressure in malignant hypertension-induced TMA has been previously shown to result in resolution of TMA and gradual return of renal function [Zhang et al. 2008]. Although high creatinine levels and systolic hypertension at presentation are associated with a lower chance of renal recovery [van den Born et al. 2005], malignant hypertension patients ultimately may have more favorable nonrenal FK228 cost prognosis than other thrombotic microangiopathies [Zhang et al. 2008]. Conclusion In conclusion, prior history of hypertension, high mean arterial pressure, significant renal impairment but relatively modest thrombocytopenia and lack of severe ADAMTS-13 deficiency (activity