Investigations in pregnancy-associated TMA
Test . | TTP . | CM-HUS . | Pregnancy-related TMAs (eg, PE, HELLP, AFLP) . |
---|---|---|---|
Hemoglobin | Reduced | Reduced | Reduced |
Platelet count | Very reduced | Reduced | Reduced/very reduced |
Reticulocytes | Increased | Increased | Normal/increased |
Fragmentation on blood film | Yes +++ | Yes ++ | Yes + |
Serum creatinine | Normal/increased | Increased | Normal/increased |
Urine protein/creatinine ratio | Normal/increased | Increased | Increased |
Coagulation screen | Normal | Normal | Normal (except AFLP; coagulation screen prolonged—decreased fibrinogen) |
Bilirubin | Increased | Increased | Mild increase |
ALT/AST | Normal | Normal | Increased |
Alkaline phosphatase | Normal | Normal | Increased in HELLP and AFLP |
Urate | Normal | Normal | Increased |
C3/C4 | Normal | Reduced C3 in some cases | Normal |
ADAMTS-13 | Severely reduced | Mildly reduced | Mildly reduced |
Test . | TTP . | CM-HUS . | Pregnancy-related TMAs (eg, PE, HELLP, AFLP) . |
---|---|---|---|
Hemoglobin | Reduced | Reduced | Reduced |
Platelet count | Very reduced | Reduced | Reduced/very reduced |
Reticulocytes | Increased | Increased | Normal/increased |
Fragmentation on blood film | Yes +++ | Yes ++ | Yes + |
Serum creatinine | Normal/increased | Increased | Normal/increased |
Urine protein/creatinine ratio | Normal/increased | Increased | Increased |
Coagulation screen | Normal | Normal | Normal (except AFLP; coagulation screen prolonged—decreased fibrinogen) |
Bilirubin | Increased | Increased | Mild increase |
ALT/AST | Normal | Normal | Increased |
Alkaline phosphatase | Normal | Normal | Increased in HELLP and AFLP |
Urate | Normal | Normal | Increased |
C3/C4 | Normal | Reduced C3 in some cases | Normal |
ADAMTS-13 | Severely reduced | Mildly reduced | Mildly reduced |
Note: the degree of involvement is demonstrated by an increasing number of +.