{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T00:15:25Z","timestamp":1783210525353,"version":"3.54.6"},"reference-count":26,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T00:00:00Z","timestamp":1766793600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Biochem"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to identify laboratory parameters that could optimize the PLASMIC score, thereby improving its diagnostic accuracy for thrombotic thrombocytopenic purpura (TTP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective analysis of 136 patients with suspected TTP who had available ADAMTS-13 activity measurements. Patients were stratified into two groups based on ADAMTS-13 activity: a TTP group (n = 49) and a non-TTP group (n = 87). Routine laboratory parameters\u2014including hemoglobin (HGB), red blood cell distribution width-standard deviation (RDW-SD), mean corpuscular volume (MCV), platelet count (PLT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), direct bilirubin (DBIL), indirect bilirubin (IBIL), lactate dehydrogenase (LDH), creatinine (CR), urea (UREA), international normalized ratio (INR), and D-dimer\u2014were compared between groups. Statistically significant parameters were selected as candidate variables to refine the PLASMIC score. The diagnostic performance of the modified model was evaluated using receiver operating characteristic (ROC) curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six parameters\u2014HGB, PLT, ALT, RDW-SD, IBIL, and LDH\u2014demonstrated significant differences between TTP and non-TTP patients. Multivariate logistic regression identified RDW-SD, PLT, and LDH as independent predictors of TTP. Based on these findings, we revised the PLASMIC score by substituting MCV with RDW-SD. The modified model exhibited a higher area under the curve (AUC) (0.907 vs 0.817) while maintaining sensitivity (95.9%) and improving specificity (70.1% vs 65.9%) compared to the original.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The modified PLASMIC score model may improve diagnostic accuracy for TTP in similar patient populations, but requires external validation in diverse cohorts to confirm its broader utility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00045632251411788","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T17:42:57Z","timestamp":1765820577000},"page":"327-335","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Improving the PLASMIC score with the use of RDW-SD in the differential diagnosis for thrombotic thrombocytopenic purpura in Chinese patients"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2468-7068","authenticated-orcid":false,"given":"Chi","family":"Zhang","sequence":"first","affiliation":[{"name":"Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Libo","family":"Xia","sequence":"additional","affiliation":[{"name":"Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuesong","family":"Lv","sequence":"additional","affiliation":[{"name":"Changyang Tujia Autonomous County People\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weixun","family":"Sun","sequence":"additional","affiliation":[{"name":"Changyang Tujia Autonomous County People\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhigang","family":"Xiong","sequence":"additional","affiliation":[{"name":"Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Fei","sequence":"additional","affiliation":[{"name":"Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,27]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(16)30018-7"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-014-3630-z"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-019-05904-7"},{"key":"e_1_3_5_5_2","first-page":"360","article-title":"International society on thrombosis and haemostasis. 2025 focused update of the 2020 ISTH guidelines for management of thrombotic thrombocytopenic purpura","volume":"17","author":"Zheng XL","year":"2025","unstructured":"Zheng XL, Al-Housni Z, Cataland SR, et al. International society on thrombosis and haemostasis. 2025 focused update of the 2020 ISTH guidelines for management of thrombotic thrombocytopenic purpura. 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Red blood cell distribution width as a prognostic biomarker for mortality in traumatic brain injury. Int J Clin Exp Med 2015; 8: 19172\u201319175.","journal-title":"Int J Clin Exp Med"},{"key":"e_1_3_5_22_2","first-page":"e24","article-title":"Red cell distribution width (RDW) index as a predictor of severity of acute ischemic stroke: a correlation study","volume":"4","author":"Mohindra R","year":"2019","unstructured":"Mohindra R, Mishra U, Mathew R, et al. Red cell distribution width (RDW) index as a predictor of severity of acute ischemic stroke: a correlation study. Adv J Emerg Med 2019; 4: e24.","journal-title":"Adv J Emerg Med"},{"key":"e_1_3_5_23_2","first-page":"4472","article-title":"Diagnostic value of joint detection of homocysteine and RDW CV on acute myocardial infarction","volume":"21","author":"Hu GX","year":"2017","unstructured":"Hu GX, Zhang J, Tian YG, et al. Diagnostic value of joint detection of homocysteine and RDW CV on acute myocardial infarction. 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