Thrombotic thrombocytopenic purpura laboratory findings: Difference between revisions
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* '''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 of, | ||
** Positive family history | ** Positive family history | ||
** Recurrent episodes | ** Recurrent episodes | ||
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** Absence of inhibitors | ** Absence of inhibitors | ||
** Persistent ADAMTS13 deficiency | ** Persistent ADAMTS13 deficiency | ||
* '''Imaging:''' | * '''Imaging:''' In cases with higher suspicion of TTP, imaging is not necessary but with focal neurological signs MRI or CT may be considered | ||
* '''Blood culture:''' | * '''Blood culture:''' Patients with fever or signs and symptoms of infections | ||
* '''Stool exam:''' | * '''Stool exam:''' Stool culture and toxin evaluation should be considered in patients with diarrhea as one of the main presentation especially bloody diarrhea | ||
* '''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. | * '''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. | ||
Revision as of 19:44, 24 August 2018
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Laboratory Findings
- CBC shows:
- Thrombocytopenia (median platelet count 10,000/microL)
- Microangiopathic hemolytic anemia [1]:
| Hemolytic anemia |
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- 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 of,
- Positive family history
- Recurrent episodes
- Onset during childhood or pregnancy
- Absence of inhibitors
- Persistent ADAMTS13 deficiency
- Imaging: In cases with higher suspicion of TTP, imaging is not necessary but with focal neurological signs MRI or CT may be considered
- Blood culture: Patients with fever or signs and symptoms of infections
- Stool exam: Stool culture and toxin evaluation should be considered in patients with diarrhea as one of the main presentation especially bloody diarrhea
- 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
- ↑ 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.