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A Practical Guide to Haemostasis


The PLASMIC Score for the Diagnosis of TTP associated with severe ADAMTS13 Deficiency

Introduction:

The PLASMIC score is a clinical prediction rule for the diagnosis of TTP associated with severe ADAMTS13 deficiency - defined as <15% normal activity.



The PLASMIC Score:

Select Criteria:

[P]
Platelet Count <30 x 109/L
Yes: 1 Point
No: 0 points
[L]
Haemolysis: Elevated reticulocyte count [>2.5%]; undetectable Haptoglobin or indirect [unconjugated] Bilirubin >2.0 mg/dL [34µmol/L]
Yes: 1 Point
No: 0 Points
[A]
Active Cancer: Treatment within the previous 12 months
Yes: 0 Points
No: 1 Point
[S]
History of Solid Organ or Stem Cell transplant
Yes: 0 Points
No: 1 Point
[M]
MCV <90fL
Yes: 1 Point
No: 0 Points
[I]
INR <1.5
Yes: 1 Point
No: 0 Points
[C]
Creatinine <2.0mg/dL [<177µmol/L]
Yes: 1 Point
No: 0 Points


Score


Max Score 7

Interpretation
0-4 Risk Group:  Low
Risk of severe ADAMTS13 Deficiency [<15% normal activity] 0%
5-6 Risk Group:  Intermediate
Risk of severe ADAMTS13 Deficiency [<15% normal activity] 6%
7 Risk Group:  High
Risk of severe ADAMTS13 Deficiency [<15% normal activity] 72%



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