Validating lactate dehydrogenase (LDH) as a component of the PLASMIC predictive tool (PLASMIC-LDH).

Content Provider	Europe PMC
Author	Liam, Christopher Chin Keong Tiao, Jim Yu-Hsiang Yap, Yee Yee Lee, Yi Lin Sathar, Jameela McRae, Simon Davis, Amanda Curnow, Jennifer Bird, Robert Choi, Philip Angchaisuksiri, Pantep Tien, Sim Leng Lam, Joyce Ching Mei Oh, Doyeun Kim, Jin Seok Yoon, Sung-Soo Wong, Raymond Siu-Ming Lauren, Carolyn Merriman, Eileen Grace Enjeti, Anoop Smith, Mark Baker, Ross Ian
Copyright Year	2023
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.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC10063598&blobtype=pdf
ISSN	2287979X
Volume Number	58
DOI	10.5045/br.2023.2022133
PubMed Central reference number	PMC10063598
Issue Number	1
PubMed reference number	36632683
Journal	Blood Research [Blood Res]
e-ISSN	22880011
Language	English
Publisher	Korean Society of Hematology
Publisher Date	2023-01-12
Access Restriction	Open
Rights License	This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2023 Korean Society of Hematology
Subject Keyword	Thrombotic microangiopathy PLASMIC score Lactate dehydrogenase (LDH)
Content Type	Text
Resource Type	Article
Subject	Hematology