Thursday, May 13, 2010

Is it DIC or TTP?

The distinction between DIC and TTP/HUS is critical for treatment decisions but sometimes difficult due to overlapping manifestations. This study published in the American Journal of Clinical Pathology looked at simple laboratory tests to help make the distinction:

Although the platelet count, prothrombin time (PT), and partial thromboplastin time were different (P less than .05) between the 2 patient groups, after regression analysis, only PT and profound thrombocytopenia remained associated with TTP-HUS (P= .001 and P= .003, respectively). A platelet count of less than 20 × 103/μL (20 × 109/L) and a PT within 5 seconds of the upper limit of the reference interval had a specificity of 92% for TTP-HUS. Our data confirm that readily available laboratory assays in the proper clinical scenario can increase the likelihood of TTP-HUS over DIC.

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