A multicenter analysis revisiting the PLASMIC score: performance limitations and the impact of age, MCV, and LDH

Blood Vessels Thrombosis & Hemostasis 2026 Open access

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Authors: Rishabh Singh, Ashley Khouri, Ho Jun Lee, Sanjana Kalvehalli Kashinath, Mukul Singal, Cecilia Peterson, Simon Bakhos Bechara, Aniket-Vijay Rao, Carley Mitchell, Chong Zhang, Peter A. Kouides, Lalitha Nayak
+2 more Ming Y. Lim, Mouhamed Yazan Abou-Ismail
DOI: 10.1016/j.bvth.2026.100163
Cited by: 2
References: 19

Abstract

1. PLASMIC score performance declined with age; MCV lacked predictive value, while LDH was a strong predictor. 2. Replacing MCV with LDH modestly improved accuracy, highlighting structural limits of equally weighted PLASMIC variables. The PLASMIC score is widely used to guide early identification of immune thrombotic thrombocytopenic purpura (iTTP), but recent studies suggest decreased performance in different populations and low predictive yield of specific components. Refining rapid diagnosis of iTTP may improve outcomes. We conducted a multicenter retrospective analysis of patients who underwent ADAMTS13 testing. We validated the PLASMIC score, evaluated predictive performance of its individual components using multivariable logistic regression, and assessed age-stratified performance in two age groups (

Fields of Study & Subjects

Complement system in diseases Blood groups and transfusion Platelet Disorders and Treatments

Publication details

Journal / source
Blood Vessels Thrombosis & Hemostasis
Publisher
Elsevier BV
Volume
3
Issue
2
Pages
100163–100163
Publication date
31 March 2026
Language
EN