1.Features of post-radioiodine whole body scan in non-invasive Follicular Thyroid Neoplasm with papillary-like nuclear features (NIFTP)
Teik Hin TAN ; Teck Huat WONG ; Soo Ching CHIN ; Boon Nang LEE
The Medical Journal of Malaysia 2018;73(3):181-182
carcinoma has been reclassified as non-invasive follicularthyroid neoplasm with papillary-like nuclear features (NIFTP)to emphasize the benign nature of this entity. In ourinstitution, we have assessed 455 patients treated withradioiodine ablation for differentiated thyroid carcinoma and20 of them were retrospectively found to fulfill the newNIFTP criteria. There was no evidence of metastasis on postradioiodine whole body scans for NIFTP cases and thesepatients were in remission subsequently. The benignfeatures of these patients’ whole body scans and goodclinical outcome following treatment further support NIFTPas a low risk thyroid neoplasm.
2.Validating lactate dehydrogenase (LDH) as a component of the PLASMIC predictive tool (PLASMIC-LDH)
Christopher Chin KEONG LIAM ; 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
Blood Research 2023;58(1):36-41
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.