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):

Elevated AST
Increased reticulocytes
Elevated PT and/or aPTT
Stool positive for Shiga toxin
Spur cells in smear
Low haptoglobin
Elevated LDH
Positive DAT
Elevated ALT
Elevated direct bilirubin
Schistocytes on smear
Low ADAMTS13
Elevated ADAMTS13
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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