Tareq Abadl: The Critical Role of ADAMTS13 Activity Testing in Diagnosing TTP
Tareq Abadl, Medical Laboratory Specialist and Director of the Blood Bank at Dr. Abdelkader Al-Mutawakkil Hospital, shared a post on LinkedIn:
“ADAMTS13 Activity Test
What is it?
A laboratory test that measures the activity of the enzyme ADAMTS13, which cleaves ultra-large von Willebrand factor (vWF) multimers into smaller, less thrombogenic fragments.
What does it detect?
Primarily used to diagnose:
- Thrombotic Thrombocytopenic Purpura (TTP)
A rare but life-threatening thrombotic microangiopathy characterized by:
- Severe thrombocytopenia
- Microangiopathic hemolytic anemia
- Neurologic symptoms
- Renal dysfunction
- Fever
Normal Reference Range:
ADAMTS13 activity: ~50–150%
(May vary slightly depending on the laboratory and assay method)
Key Diagnostic Point:
Low ADAMTS13 activity less than 10% – Strongly diagnostic of TTP
The deficiency may be:
- Immune-mediated (autoantibodies against ADAMTS13)
- Congenital (hereditary deficiency)
Why is this test critical?
- TTP is not diagnosed by routine coagulation tests
- Delayed diagnosis can be fatal
- Plasma exchange (PLEX) must be started immediately when TTP is suspected.
Think TTP if you see:
- Decreased Platelets
- Elevated LDH
- Decreased Haptoglobin
- Normal PT / aPTT
Suspect TTP and order ADAMTS13 activity urgently.”

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