title: Absolute immature platelet count helps differentiate thrombotic thrombocytopenic purpura from hypertension-induced thrombotic microangiopathy.
abstract: ADAMTS13 activity measurement is used in the diagnostic algorithm of thrombotic thrombocytopenic purpura (TTP), but results may not be available before initiation of therapeutic plasma exchange (TPE). The immature platelet fraction (%-IPF) and the calculated absolute immature platelet count (A-IPC) represent a test of real-time thrombopoiesis, and can be performed in most laboratories using automated analyzers. Here we report on using A-IPC kinetics to exclude idiopathic TTP in a patient with severe hypertension, thrombocytopenia, and acute renal failure, which was confirmed by a normal ADAMTS13. The complete resolution of thrombocytopenia occurred once blood pressure was controlled favoring a diagnosis of hypertension-induced thrombotic microangiopathy.
authors.affiliation: Department of Pathology, University Hospitals Case Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Department of Pathology, University Hospitals Case Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Hong
authors.affiliation: Department of Pathology, University Hospitals Case Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA.
authors.forename: Hollie M
authors.initials: HM
authors.lastname: Reeves
authors.affiliation: Department of Pathology, University Hospitals Case Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA. Electronic address: robert.maitta@case.edu.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Maitta
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000175:diagnosis; D010976:Platelet Count; D011697:Purpura, Thrombotic Thrombocytopenic / Q000097:blood / Q000175:diagnosis; D034061:Thrombopoiesis; D057049:Thrombotic Microangiopathies / Q000097:blood / Q000175:diagnosis
keywords: %-IPF; Absolute immature platelet count; Hypertension; Therapeutic plasma exchange; Thrombotic microangiopathy; Thrombotic thrombocytopenic purpura