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

Liam C.C.K.; Tiao J.Y.H.; Yap Y.Y.; Lee Y.L.; Sathar J.; McRae S.; Davis A.; Curnow J.; Bird R.; Choi P.; Angchaisuksiri P.; Tien S.L.; Lam J.C.M.; Oh D.; Kim J.S.; Yoon S.S.; Wong R.S.M.; Lauren C.; Merriman E.G.; Enjeti A.; Smith M.; Baker R.I.

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

Issued Date

2023-03-01

Resource Type

Article

ISSN

2287979X

eISSN

22880011

DOI

10.5045/br.2023.2022133

Scopus ID

2-s2.0-85154614243

Journal Title

Blood Research

Volume

58

Issue

1

Start Page

36

End Page

41

Rights Holder(s)

SCOPUS

Bibliographic Citation

Blood Research Vol.58 No.1 (2023) , 36-41

Suggested Citation

Liam C.C.K., Tiao J.Y.H., Yap Y.Y., Lee Y.L., Sathar J., McRae S., Davis A., Curnow J., Bird R., Choi P., Angchaisuksiri P., Tien S.L., Lam J.C.M., Oh D., Kim J.S., Yoon S.S., Wong R.S.M., Lauren C., Merriman E.G., Enjeti A., Smith M., Baker R.I. Validating lactate dehydrogenase (LDH) as a component of the PLASMIC predictive tool (PLASMIC-LDH). Blood Research Vol.58 No.1 (2023) , 36-41. 41. doi:10.5045/br.2023.2022133 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82365

Title

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

Other Contributor(s)

Mahidol University

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.

Keyword(s)

Medicine

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/82365

Collections

Scopus 2023

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