{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T15:23:28Z","timestamp":1777044208929,"version":"3.51.4"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T00:00:00Z","timestamp":1660953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with Human Immunodeficiency Virus (HIV) infection are at risk of thrombotic microangiopathies (TMAs) notably thrombotic thrombocytopenic purpura (TTP) and disseminated intravascular coagulation (DIC). Overlap between laboratory results exists resulting in diagnostic ambiguity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Routine laboratory results of 71 patients with HIV\u2010associated TTP (HIV\u2010TTP) and 81 with DIC with concomitant HIV infection (HIV\u2010DIC) admitted between 2015 and 2021 to academic hospitals in Johannesburg, South Africa were retrospectively reviewed. Both the PLASMIC and the International Society of Thrombosis and Haemostasis (ISTH) DIC scores were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with HIV\u2010TTP had significantly (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) increased schistocytes and features of hemolysis including elevated lactate dehydrogenase (LDH)\/upper\u2010limit\u2010of\u2010normal ratio (median of 9 (interquartile range [IQR] 5\u201012) vs 3 (IQR 2\u20105)) but unexpectedly lower fibrinogen (median 2.8 (IQR 2.2\u20103.4) vs 4\u00a0g\/L (IQR 2.5\u20109.2)) and higher D\u2010dimer (median 4.8 (IQR 2.4\u20108.1) vs 3.6\u00a0g\/L (IQR 1.7\u20106.2)) levels vs the HIV\u2010DIC cohort. Patients with HIV\u2010DIC were more immunocompromised with frequent secondary infections, higher platelet and hemoglobin levels, more deranged coagulation parameters and less hemolysis. Overlap in scoring systems was however observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The laboratory parameter overlap between HIV\u2010DIC and HIV\u2010TTP might reflect a shared pathogenesis including endothelial dysfunction and inflammation and further research is required. Fibrinogen in DIC may be elevated as an acute phase reactant and D\u2010dimers may reflect the extensive hemostatic activation in HIV\u2010TTP. Inclusion of additional parameters in TMA scoring systems such the LDH\/upper\u2010limit\u2010of\u2010normal ratio, schistocytes count and wider access to ADAMTS\u201013 testing may enhance diagnostic accuracy and ensure appropriate utilization of plasma.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jca.22003","type":"journal-article","created":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T07:56:40Z","timestamp":1660982200000},"page":"460-467","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Distinguishing and overlapping laboratory results of thrombotic microangiopathies in HIV infection: Can scoring systems assist?"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4315-1496","authenticated-orcid":false,"given":"Susan","family":"Louw","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Haematology, Faculty of Health Sciences University of the Witwatersrand (Wits) and National Health Laboratory Service (NHLS)  Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barry Frank","family":"Jacobson","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Haematology, Faculty of Health Sciences University of the Witwatersrand (Wits) and National Health Laboratory Service (NHLS)  Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6360-3488","authenticated-orcid":false,"given":"Elizabeth Sarah","family":"Mayne","sequence":"additional","affiliation":[{"name":"Division of Immunology, Department of Pathology, Faculty of Health Sciences University of the Cape Town (UCT) and National Health Laboratory Service (NHLS)  Cape Town South 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