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:

“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.

Based on MacDonald et al., British Journal of Haematology 2026 BSH laboratory guidance.”

Nawsherwan Mohammad: Recognizing TTP Before the ADAMTS13 Result Arrives