Nishimura et al used a simple group of laboratory tests to distinguish TTP from sepsis-related DIC when ADAMTS13 is not available. The authors are from Nara Medica University and Uda Municipal Hospital in Nara, Japan.
Parameters:
(1) PLASMIC score, from 0 to 7
(2) serum LDH in IU/L
(3) hemoglobin in g/L
LDH to hemoglobin ratio in IU per 10 g hemoglobin =
= (LDH) / ((hemoglobin) / 10)
A PLASMIC score of 6 or 7 is seen in TTP, while a PLASMIC score from 0 to 3 is seen in DIC. The problem is that scores of 4 or 5 is indeterminate.
An LDH to hemoglobin ratio > 53.7 is seen mostly in TTP, while a lower score is more often seen with DIC.
In addition, an INR > 1.5 is seen with DIC (provided that the INR was normal prior to the illness).
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