Thrombotic thrombocytopenic purpura laboratory findings: Difference between revisions

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* '''Urine output:''' Decreased  
* '''Urine output:''' Decreased  
* '''ADAMTS13 activity test:''' Decreased to < 10% during acute episodes of TTP.   
* '''ADAMTS13 activity test:''' Decreased to < 10% during acute episodes of TTP.   
* ADAMTS13 inhinbitors test:   
* '''ADAMTS13 inhinbitors test:'''  
* '''Genetic testing:''' Should be done in suspected cases
* '''Genetic testing:''' Should be done in suspected cases
** Positive family history   
** Positive family history   

Revision as of 19:35, 24 August 2018

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Laboratory Findings

  • CBC shows:
    • Thrombocytopenia (median platelet count 10,000/microL)
    • Microangiopathic hemolytic anemia [1]:
Hemolytic anemia
  • LDH ↑
  • Indirect bilirubin ↑
  • Serum haptoglubin ↓
  • Retic count ↑
  • Combs tests negative
  • Hb ~7 g/dl, Hct ~21%
  • Peripheral blood smear: Schistocytes, including helmet cells and triangular cells, polychromasia, microspherocytes and nucleated RBCs
  • Urinalysis: Hematuria, proteinuria
  • Serum creatinine: Increased
  • Urine output: Decreased
  • ADAMTS13 activity test: Decreased to < 10% during acute episodes of TTP.
  • ADAMTS13 inhinbitors test:
  • Genetic testing: Should be done in suspected cases
    • Positive family history
    • Recurrent episodes
    • Onset during childhood or pregnancy
    • Absence of inhibitors
    • Persistent ADAMTS13 deficiency
  • Imaging:
  • Blood culture:
  • Stool exam:
  • Pathology: Tissue biopsy is not necessary for diagnosis, but it may show classic changes of a thrombotic microangiopathy including platelet microthrombi in small arterioles or capillaries, or hyaline changes in and around vessel walls.

References

  1. BRAIN MC, DACIE JV, HOURIHANE DO (1962). "Microangiopathic haemolytic anaemia: the possible role of vascular lesions in pathogenesis". Br J Haematol. 8: 358–74. PMID 14014893.

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