Acute thrombotic thrombocytopenic purpura in Louisiana : Seasonal distribution and evaluation of an ADAMTS13 order screening protocol

© 2020 Wiley Periodicals, Inc..

BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disorder caused by inactivation of ADAMTS13. It is characterized by thrombocytopenia and microangiopathic hemolytic anemia. Previous studies have produced conflicting data regarding seasonal association of TTP diagnoses. This study evaluated the seasonal distribution of acute TTP in southern Louisiana. Additionally, this study timeline overlapped with the initiation of a new screening protocol for ADAMTS13 testing.

STUDY DESIGN AND METHODS: A retrospective analysis of patients receiving ADAMTS13 testing at Ochsner Medical Center from January 2010 to December 2017 was performed. TTP patient episodes were defined by ADAMTS13 activity <10%. Episodes were plotted according to season of presentation and a chi-square analysis was performed. Data of identified TTP patients was analyzed to evaluate for confounding variables. ADAMTS13 order volumes and results before and after screening protocol implementation were compared.

RESULTS: Two hundred and fifty-two ADAMTS13 tests were ordered on 245 unique patients. Twenty-five patients had ADAMTS13 activity <10%. No significant differences in seasonal TTP case distribution were identified. Patients with confirmed TTP were younger and more likely to be Black or African American. A screening protocol did not decrease the number of annual ADAMTS13 test orders in our time frame, but was associated with a nonsignificant increase in the percentage of positive results.

CONCLUSION: No significant seasonal distribution of TTP was identified in our population. This analysis provides previously unexamined regional information regarding this diagnosis. The number of tests ordered after the implementation of the screening protocol increased, corresponding with our facility's expanding reach.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:35

Enthalten in:

Journal of clinical apheresis - 35(2020), 4 vom: 01. Aug., Seite 264-270

Sprache:

Englisch

Beteiligte Personen:

Simenson, Victoria [VerfasserIn]
Burton, Jeffrey [VerfasserIn]
Del Toro, Alejandra [VerfasserIn]
Alquist, Caroline Raasch [VerfasserIn]

Links:

Volltext

Themen:

ADAMTS13
ADAMTS13 Protein
ADAMTS13 protein, human
Apheresis
EC 3.4.24.87
Journal Article
Lab utilization
Therapeutic plasma exchange
Thrombotic microangiopathy
Thrombotic thrombocytopenic purpura

Anmerkungen:

Date Completed 02.08.2021

Date Revised 02.08.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1002/jca.21786

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM309911699