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Research ArticleResearch and Reports

An Overview of the Laboratory’s Role in the Diagnosis and Treatment of Thrombotic Thrombocytopenic Purpura

Billie Ketelsen
American Society for Clinical Laboratory Science April 2023, DOI: https://doi.org/10.29074/ascls.2020002253
Billie Ketelsen
Oakland University
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    Table 1.

    Original patient laboratory values for a 40-year-old female who was seen in the emergency department with abdominal pain over 3 days


    Hematology
    Reference IntervalOriginal
    Patient Values
    WBC, bil/L3.3–10.74.7
    RBC, tril/L3.87–5.083.3
    Hemoglobin, g/dl12.1–159.0
    Hematocrit, %34.4–44.227.8
    MCV, fL80–10084
    MCH, pg28–3227
    MCHC, %32–3632
    RDW, %11.5–15.520
    Platelet, bil/L150–40032
    MPV, fL8.5–12.514
    IPF, %1–1115
    Neutrophils, bil/L1.6–7.23.2
    Lymphocytes, bil/L1.1–4.01
    Monocytes, bil/L0.0–0.80.4
    Eosinophils, bil/L0.0–0.50.0
    Basophils, bil/L0.0–0.10.0
    Immature granulocytes, bil/L0.00–0.030.01
    RBC morphology <1/hpfschistocytes 3–5; polychromasia 1–3
    Coagulation
     PT, s9.5–12.311.8
     aPTT, s24.3–32.229.7
     Fibrinogen, mg/dl180–400319
     ADAMTS13 activity, %50–160<5
     ADAMTS13 inhibitor, BU<0.42
    Chemistry 
     LDH, U/L140–280 362
     Creatinine0.5–1.01.2
     Bilirubin, mg/dl0.2–1.23.6
    Urinalysis—completed day prior to above results
     Test strip results
      ColorYellowDark Yellow
      ClarityClearCloudy
      GlucoseNegativeNegative
      BilirubinNegativeNegative
      KetonesNegativeNegative
      Specific gravity1.003–1.0351.017
      Blood Negative3+
      pH 5.0–8.07.0
      Protein, mg/dl Negative100
      Urobilinogen, mg/dl0.2–12
      NitratesNegativeNegative
      Leukocyte esteraseNegativeNegative
     Urinary sediment
      RBC 0–2 (negative)0–2 (negative)
      WBC 0–2 (negative)3–10
      Epithelial, squamous0–5 (negative)>50
      Casts, hyaline0–2 (negative)0–2 negative
      Bacteria0–1+ (negative)1+

    Abbreviations: ADAMTS13, a disintegrin and metalloprotease with thrombospondin type 1 repeats, member 13; aPTT, activated partial thromboplastin time; BU, blood unit; IPF, immature platelet fraction; LDH, lactic acid dehydrogenase; MCH, mean cell hemoglobin; MCHC, mean cell hemoglobin concentration; MCV, mean cell volume; MPV, mean platelet volume; PT, prothrombin time; RBC, red blood cell; RDW, red cell distribution width; WBC, white blood cell.

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    American Society for Clinical Laboratory Science: 37 (2)
    American Society for Clinical Laboratory Science
    Vol. 37, Issue 2
    1 Apr 2024
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    An Overview of the Laboratory’s Role in the Diagnosis and Treatment of Thrombotic Thrombocytopenic Purpura
    Billie Ketelsen
    American Society for Clinical Laboratory Science Apr 2023, DOI: 10.29074/ascls.2020002253

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    An Overview of the Laboratory’s Role in the Diagnosis and Treatment of Thrombotic Thrombocytopenic Purpura
    Billie Ketelsen
    American Society for Clinical Laboratory Science Apr 2023, DOI: 10.29074/ascls.2020002253
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    Keywords

    • ADAMTS - a disintegrin and metalloprotease with thrombospondin type 1 repeats
    • ADAMTS13 - a disintegrin and metalloprotease with thrombospondin type 1 repeats, member 13
    • MAHA - microangiopathic hemolytic anemia
    • TPE - therapeutic plasma exchange
    • TTP - thrombotic thrombocytopenic purpura
    • VWF - von Willebrand factor
    • thrombotic thrombocytopenic purpura
    • ADAMTS13
    • von Willebrand factor

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