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