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Journal article
Validating lactate dehydrogenase (LDH) as a component of the PLASMIC predictive tool (PLASMIC-LDH)
Blood research, Vol.58(1), pp.36-41
2023
PMID: 36632683
Abstract
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.
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.
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%.
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.
Details
- Title
- Validating lactate dehydrogenase (LDH) as a component of the PLASMIC predictive tool (PLASMIC-LDH)
- Authors/Creators
- Christopher Chin Keong Liam - Murdoch UniversityJim Yu-Hsiang Tiao - Murdoch UniversityYee Yee Yap - KPJ Ampang Puteri Specialist HospitalYi Lin Lee - KPJ Ampang Puteri Specialist HospitalJameela Sathar - KPJ Ampang Puteri Specialist HospitalSimon McRae - Northern (Arctic) Federal UniversityAmanda Davis - The Alfred HospitalJennifer Curnow - Westmead HospitalRobert Bird - Princess Alexandra HospitalPhilip Choi - Canberra HospitalPantep Angchaisuksiri - Ramathibodi HospitalSim Leng Tien - Singapore General HospitalJoyce Ching Mei Lam - KK Women's and Children's HospitalDoyeun Oh - Internal Medicine, Cha Bundang Medical Centre, Cha University, Seongnam, KoreaJin Seok Kim - Yonsei UniversitySung-Soo Yoon - Seoul National University HospitalRaymond Siu-Ming Wong - Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong KongCarolyn Lauren - Canterbury District Health BoardEileen Grace Merriman - North Shore HospitalAnoop Enjeti - Calvary Mater Newcastle HospitalMark Smith - Canterbury District Health BoardRoss Ian Baker - Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics
- Publication Details
- Blood research, Vol.58(1), pp.36-41
- Publisher
- The Korean Society of Hematology
- Identifiers
- 991005568769707891
- Copyright
- © The Korean Society of Hematology
- Murdoch Affiliation
- Western Australian Centre for Thrombosis and Haemostasis
- Language
- English
- Resource Type
- Journal article
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