Evaluation of the Plasmic Score for the Prediction of Adamts13 Activity in Patients with Thrombotic Microangiopathies

Tiscia, Giovanni Luca; Cappucci, Filomena; Scalzulli, Potito Rosario; Cascavilla, Nicola; Battista, Cosima; Abrescia, Antonio; Aucella, Filippo; Buquicchio, Caterina; Brigante, Maurizio; D’Andrea, Giovanna; Paolo, B. Di; Giordano, Giulio; Infante, Barbara; Piano, S.; Ranieri, P; Tullo, Livio; Ostuni, Angelo; Grandone, E.

doi:10.3390/proceedings2090533

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“…In the original study about the PLAMSIC score, the specificity in the internal validation cohort is 31%, 58.44% in the external validation cohort. The specificity is 55.68%, 51.78%, 60% and 25.6% in another four validation cohorts study (Table ) . These diversities between our and other validations may be caused by the low percentage of patients in low‐risk group (0‐4), 5.26%.…”

Section: Discussionmentioning

confidence: 47%

“…In order to solve this difficulty, many doctors and scientists had tried to use available clinical data to predict TTP, such as the Bentley score, Coppo score, the PLASMIC score, and so on . Among the scores, the PLASMIC score has proved to be practical and effective, which was validated in some studies . However, according to our data, we found that the PLASMIC score may be not suitable to our Chinese suspected TTP patients.…”

Section: Discussionmentioning

confidence: 79%

“…However, patients in previous derivation and validation cohorts of the PLASMIC score were from New England, Pacific Northwest, Germany, and South Italy and in these various cohorts, the percentage of TTP patients are different, range from 14% to 61.5%, and it is unclear whether this score is suitable for other populations, such as Chinese patients with suspected TTP.…”

Section: Introductionmentioning

confidence: 99%

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A modified PLASMIC score including the lactate dehydrogenase/the upper limit of normal ratio more accurately identifies Chinese thrombotic thrombocytopenic purpura patients than the original PLASMIC score

Zhao

Zhou

et al. 2019

J of Clinical Apheresis

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Background: The PLASMIC score was recently published to aid in the early identification of thrombotic thrombocytopenic purpura (TTP) patients. This study aims to evaluate whether this score is suitable for Chinese suspected TTP patients and find the utility of patients' other characteristics in predicting severe ADAMTS13 deficiency. Methods: We retrospectively studied a Chinese cohort of 38 consecutive hospitalized patients with suspected TTP, ADAMTS13 test results, and other clinical data from September 2016 to May 2018. The predictive power of PLASMIC score in our cohort was evaluated, and patients' other characteristics, especially the high lactate dehydrogenase/the upper limit of normal (LDH/ULN), were studied to determine their distinguishing ability for TTP patients.Results: In this Chinese cohort, 17 patients were diagnosed with TTP according to ADAMTS13 activity results. When dichotomized at intermediate-high risk (scores 5-7) vs low risk (scores 0-4), the PLASMIC score predicted TTP with a sensitivity of 100%, a specificity of 9.52%, and a misdiagnosis rate of 90.48%. And the LDH/ULN alone, or plus platelet count, reticulocyte percentage and indirect bilirubin (IBIL) both had excellent predictive power (area under the curve [AUC] 0.937, 95% confidence interval [CI] 0.863-1.000, P = .000, and AUC 0.994, 95% CI 0.980-1.000, P = .000, respectively). The model including platelet count, reticulocyte percentage, IBIL, and LDH/ULN ratio had a sensitivity of 100%, a specificity of 95.2%, and a misdiagnosis rate of 4.8%.Conclusions: A modified PLASMIC score plus LDH/ULN ratio might be more suitable for identifying ADAMTS13 deficiency patients, especially for making an earlier diagnosis, guiding the immediate and reasonable plasma exchange, and also avoiding unnecessary allocation of plasma. K E Y W O R D SADAMTS13 activity, lactate dehydrogenase, PLASMIC score

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

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A modified PLASMIC score including the lactate dehydrogenase/the upper limit of normal ratio more accurately identifies Chinese thrombotic thrombocytopenic purpura patients than the original PLASMIC score

Zhao

Zhou

et al. 2019

J of Clinical Apheresis

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Evaluation of the Plasmic Score for the Prediction of Adamts13 Activity in Patients with Thrombotic Microangiopathies

Abstract: Abstract:The PLASMIC score for the prediction of a likelihood of a severe ADAMTS13 deficiency represents a valid pre-test diagnostic tool to identify patients with thrombotic thrombocytopenic purpura.

Cited by 1 publication

References 1 publication

A modified PLASMIC score including the lactate dehydrogenase/the upper limit of normal ratio more accurately identifies Chinese thrombotic thrombocytopenic purpura patients than the original PLASMIC score

A modified PLASMIC score including the lactate dehydrogenase/the upper limit of normal ratio more accurately identifies Chinese thrombotic thrombocytopenic purpura patients than the original PLASMIC score

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