ArticleTransfusion2021
Reduced sensitivity of PLASMIC and French scores for the diagnosis of thrombotic thrombocytopenic purpura in older individuals.
Article in Transfusion, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 51 citations in OpenAlex.
- Revisiting clinical scoring tools for the diagnosis of thrombotic thrombocytopenic purpura (TTP).Journal of thrombosis and thrombolysis · 2026Review
- Revisiting clinical scoring tools for the diagnosis of thrombotic thrombocytopenic purpura (TTP).Journal of thrombosis and thrombolysis · 2026Review
- Revisiting clinical scoring tools for the diagnosis of thrombotic thrombocytopenic purpura (TTP).Journal of thrombosis and thrombolysis · 2026Review
- Revisiting the PLASMIC score and the future of ADAMTS13 prediction.Blood vessels, thrombosis & hemostasis · 2026Article
- A multicenter analysis revisiting the PLASMIC score: performance limitations and the impact of age, MCV, and LDH.Blood vessels, thrombosis & hemostasis · 2026Article
- Article
- PLASMIC score to aid diagnosis of aHUS: an analysis of C5 inhibitor clinical trials and the PINC AI™ healthcare database.BMC nephrology · 2025Article
- Caplacizumab treatment in elderly patients with iTTP: Experience from the Spanish TTP Registry.HemaSphere · 2025Article
- Thrombotic Thrombocytopenic Purpura and Evans Syndrome: Validating and Exploring 20 Years of Routine Hospital Care.Journal of blood medicine · 2025Article
- The TMA team and TTP pathway improved outcomes in a cohort with Thrombotic thrombocytopenic purpura.PloS one · 2025Article
- ADAMTS13 in the New Era of TTP.International journal of molecular sciences · 2024Review
- How We Interpret Thrombosis with Thrombocytopenia Syndrome?International journal of molecular sciences · 2024Review
- Pathological Mechanisms and Novel Testing Methods in Thrombotic Thrombocytopenic Purpura.Biomedicines · 2024Review
- Medical consult: aHUS, TTP? How to distinguish and what to do.Hematology. American Society of Hematology. Education Program · 2023Article
- Immune Thrombotic Thrombocytopenic Purpura in Elderly Patients: The Roles of PLASMIC and French ScoresTurkish journal of haematology : official journal of Turkish Society of Haematology · 2023Article
- Performance Validation of Three Scoring Systems for the Prediction of Thrombotic Microangiopathy Due to Severe ADAMTS13 Deficiency and the Response to Therapeutic Plasma Exchange: First Study in Korea.Annals of laboratory medicine · 2023Article
- Global Health Resource Utilization and Cost-Effectiveness of Therapeutics and Diagnostics in Immune Thrombotic Thrombocytopenic Purpura (TTP).Journal of clinical medicine · 2023Review
- Validation of PLASMIC score in a cohort of patients with suspected thrombotic microangiopathy in an academic medical centre.Blood transfusion = Trasfusione del sangue · 2023Article
- Article
- The Specificities of Thrombotic Thrombocytopenic Purpura at Extreme Ages: A Narrative Review.Journal of clinical medicine · 2023Review
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundThrombotic thrombocytopenic purpura (TTP) is a life-threatening disorder characterized by thrombocytopenia, microangiopathic hemolysis, and ischemic organ failure. The PLASMIC and French TTP scores can help guide clinical decisions when ADAMTS13 testing is not immediately available. Older individuals often present atypically, but the impact of age on these tools is not known. STUDY DESIGN AND
methodsWe calculated the sensitivity and specificity of the PLASMIC and French TTP scores in patients enrolled in the Johns Hopkins thrombotic microangiopathy (TMA) registry.
resultsOf 257 patients with TMA enrolled in the registry, we excluded patients less than 18 years of age (n = 19), with prior TMA (n = 81) or who initially presented at another hospital (n = 25). The remaining 132 patients (75 with TTP and 57 with other TMA) were analyzed. Sensitivity of a French score of 2 decreased with age and was 72.2%, 61.5%, and 46.2% for ages 18 to 39, 40 to 59, and ≥ 60 years old, respectively. A PLASMIC score ≥ 5 had higher sensitivity than the French score but this also decreased with age; sensitivity was 91.4% (95% confidence interval [CI], 76.9-98.2), 78.3% (95% CI, 56.3-92.5), and 76.9% (95% CI, 46.2-95.0) for patients 18 to 39, 40 to 59, and ≥ 60 years old, respectively. Older patients had higher platelet counts and serum creatinine than the youngest group, contributing to the loss in sensitivity.
conclusionThe PLASMIC and French TTP scores have reduced sensitivity at age ≥ 60 years and are less reliable in identifying TTP in older patients. A high index of suspicion and availability of rapid ADAMTS13 assays is required to correctly diagnose all patients with TTP.
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