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Nawsherwan Mohammad: Recognizing TTP Before the ADAMTS13 Result Arrives
Nawsherwan Mohammad/LinkedIn
Oct 5, 2026, 13:01

Nawsherwan Mohammad: Recognizing TTP Before the ADAMTS13 Result Arrives

Nawsherwan Mohammad, Consultant Hematopathologist at Nanakaly Hospital, shared a post on LinkedIn about a recent article by Stephen MacDonald et al., published in BJHaem, adding:

“Suspected TTP is a medical emergency – don’t wait for ADAMTS13 to treat when clinical suspicion is high.

A practical summary of the 2026 BSH laboratory guidance on thrombotic thrombocytopenic purpura:

  • Think TTP when thrombocytopenia plus microangiopathic haemolytic anaemia occur together.
  • Look for marked thrombocytopenia, schistocytes, reticulocytosis, elevated LDH, low haptoglobin, and usually normal coagulation.
  • Send a pre-treatment ADAMTS13 sample – ideally 3.2% sodium citrate, not EDTA – but never delay treatment.
  • ADAMTS13 activity less than 10 IU/dL strongly supports TTP.
  • 10–20 IU/dL is a grey zone, not an automatic negative.
  • If less than 10 IU/dL, test anti-ADAMTS13 antibodies within 72 hours.
  • Antibody-negative does not prove congenital TTP – genetic testing is required.
  • For monitoring, use the same assay platform whenever possible.

Key message: rapid recognition, early sampling, and urgent treatment save lives.”

Title: Diagnosis and monitoring of thrombotic thrombocytopenic purpura: Guidance for laboratories from the British Society for Haematology

Authors: Stephen MacDonald, Thomas Pitchford, Deepak Singh, Rebekah Fretwell, P. Vince Jenkins, Caroline Lawrence, Richard Gooding, Sean Platton

Nawsherwan Mohammad: Recognizing TTP Before the ADAMTS13 Result Arrives

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ADAMTS13 BJHaem British Journal of Haematology BSH Caroline Lawrence Deepak Singh Health Hematology Hemostasis Hemostasis News Hemostasis Today Medicine Nawsherwan Mohammad P. Vince Jenkins Rebekah Fretwell Richard Gooding Sean Platton Stephen MacDonald Thomas Pitchford thrombosis TTP
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