Validating lactate dehydrogenase (LDH) as a component of the PLASMIC predictive tool (PLASMIC-LDH)
- Author:
Christopher Chin KEONG LIAM
1
;
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
;
Doyeun OH
;
Jin Seok KIM
;
Sung-Soo YOON
;
Raymond Siu-Ming WONG
;
Carolyn LAUREN
;
Eileen Grace MERRIMAN
;
Anoop ENJETI
;
Mark SMITH
;
Ross Ian BAKER
Author Information
- Publication Type:ORIGINAL ARTICLE
- From:Blood Research 2023;58(1):36-41
- CountryRepublic of Korea
- Language:English
-
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.
