Knowledge Check

Of the various lab tests, which is diagnostic of thrombotic thrombocytopenic purpura (TTP)?

a
Elevated LDH
b
Low haptoglobin
c
Elevated CRP
d
Low ADAMTS13 activity
Correct. ADAMTS13 activity < 10% is diagnostic of TTP.
e
Mutation analysis of ADAMTS13

Sort lab test (top) according to whether it is typically altered in TTP or not (bottom):

Low ADAMTS13
Increased reticulocytes
Low haptoglobin
Elevated PT and/or aPTT
Spur cells in smear
Elevated ADAMTS13
Stool positive for Shiga toxin
Elevated AST
Elevated LDH
Positive DAT
Schistocytes on smear
Elevated direct bilirubin
Elevated ALT
Altered in TTP
Not altered in TTP

Abbreviations: TTP, thrombotic thrombocytopenic purpura; LDH, lactate dehydrogenase; DAT, direct antiglobulin test; PT, prothrombin time; aPTT, activated partial thromboplastin time.

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