|
KMID : 1142020230580010036
|
|
Blood Research
2023 Volume.58 No. 1 p.36 ~ p.41
|
|
|
Validating lactate dehydrogenase (LDH) as a component of the PLASMIC predictive tool (PLASMIC-LDH)
|
|
Christopher Chin Keong Liam
Jim Yu-Hsiang Tiao
Yee Yee Yap
Yi Lin Lee
Jameela Sathar
Simon McRae
Amanda Davis
Jennifer Curnow
Robert Bird
Philip Choi
Pantep Angchaisuksiri
Sim Leng Tien
Joyce Ching Mei Lam
Oh Do-Yeun
Kim Jin-Seok
Yoon Sung-Soo
Raymond Siu-Ming Wong
Carolyn Lauren
Eileen Grace Merriman
Anoop Enjeti
Mark Smith
Ross Ian Baker
|
|
|
Abstract
|
|
|
Background The PLASMIC score is a convenient tool for predicting ADAMTS13 activity of ＜10%.
Lactate dehydrogenase (LDH) is widely used as a marker of haemolysis in thrombotic thrombocytopenic purpura (TTP) monitoring, and could be used as a replacement marker for lysis. We aimed to validate the PLASMIC score in a multi-centre Asia Pacific region, and to explore whether LDH could be used as a replacement marker for lysis.
Methods Records of patients with thrombotic microangiopathy (TMA) were reviewed. Patients’ ADAMTS13 activity levels were obtained, along with clinical/laboratory findings relevant to the PLASMIC score. Both PLASMIC scores and PLASMIC-LDH scores, in which LDH replaced traditional lysis markers, were calculated. We generated a receiver operator characteristics (ROC) curve and compared the area under the curve values (AUC) to determine the predictive ability of each score.
Results 46 patients fulfilled the inclusion criteria, of which 34 had ADAMTS13 activity levels of ＜10%. When the patients were divided into intermediate-to-high risk (scores 5?7) and low risk (scores 0?4), the PLASMIC score showed a sensitivity of 97.1% and specificity of 58.3%, with a positive predictive value (PPV) of 86.8% and negative predictive value (NPV) of 87.5%. The PLASMIC-LDH score had a sensitivity of 97.1% and specificity of 33.3%, with a PPV of 80.5% and NPV of 80.0%.
Conclusion Our study validated the utility of the PLASMIC score, and demonstrated PLASMIC-LDH as a reasonable alternative in the absence of traditional lysis markers, to help identify high-risk patients for treatment via plasma exchange.
|
|
|
KEYWORD
|
|
|
Thrombotic microangiopathy, PLASMIC score, Lactate dehydrogenase (LDH)
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|