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Rapid ADAMTS 13 availability impacts treatment for microangiopathic hemolytic anemia and thrombocytopenia
Author(s) -
Martin Isabella W.,
Katus Matthew C.,
Martin ChristiLynn B.,
Szczepiorkowski Zbigniew M.,
Gorham James D.,
Dunbar Nancy M.
Publication year - 2016
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.21419
Subject(s) - medicine , thrombotic thrombocytopenic purpura , adamts13 , microangiopathic hemolytic anemia , therapeutic plasma exchange , thrombospondin , plasmapheresis , apheresis , gastroenterology , platelet , metalloproteinase , surgery , immunology , antibody , matrix metalloproteinase
Thrombotic thrombocytopenic purpura (TTP) can present with a spectrum of clinical manifestations. When TTP is in a patient's clinical differential diagnosis, therapeutic plasma exchange (TPE) should be initiated emergently. Enzyme activity level of A Disintegrin And Metalloproteinase with a Thrombospondin type 1 motif, member 13 (ADAMTS13) in conjunction with the evolving clinical picture can guide further therapy, including duration and frequency of TPE and choice of fluid replacement. Our experience switching reference laboratories to obtain a more rapid turnaround time of ADAMTS13 activity level resulted in significant changes in clinical management, including fewer overall TPE procedures and the occasional use of albumin for a portion of the replacement fluid in patients without severe deficiency of ADAMTS13 and a low index of clinical suspicion for TTP. J. Clin. Apheresis 31:419–422, 2016. © 2015 Wiley Periodicals, Inc.