{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T12:05:58Z","timestamp":1790424358546,"version":"4.1.0"},"reference-count":26,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,27]],"date-time":"2022-01-27T00:00:00Z","timestamp":1643241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Early diagnosis of thrombotic thrombocytopenic purpura (TTP) versus hemolytic and uremic syndrome (HUS) is critical for the prompt initiation of specific therapies. Objective: To evaluate the diagnostic performance of the proteinuria\/creatininuria ratio (PU\/CU) for TTP versus HUS. Patients\/Methods: In a retrospective study, in association with the \u201cFrench Score\u201d (FS) (platelets &lt; 30 G\/L and serum creatinine level &lt; 200 \u00b5mol\/L), we assessed PU\/CU for the diagnosis of TTP in patients above the age of 15 with thrombotic microangiopathy (TMA). Patients with a history of kidney disease or with on-going cancer, allograft or pregnancy were excluded from the analysis. Results: Between February 2011 and April 2019, we identified 124 TMA. Fifty-six TMA patients for whom PU\/CU were available, including 35 TTP and 21 HUS cases, were considered. Using receiver\u2013operating characteristic curves (ROC), those with a threshold of 1.5 g\/g for the PU\/CU had a 77% sensitivity (95% CI (63, 94)) and a 90% specificity (95% CI (71, 100)) for TTP diagnosis compared with those having an 80% sensitivity (95% CI (66, 92)) and a 90% specificity (95% CI (76, 100) with a FS of 2. In comparison, a composite score, defined as a FS of 2 or a PU\/CU \u2264 1.5 g\/g, improved sensitivity to 99.6% (95% CI (93, 100)) for TTP diagnosis and enabled us to reclassify seven false-negative TTP patients. Conclusions: The addition of urinary PU\/CU upon admission of patients with TMA is a fast and readily available test that can aid in the differential diagnosis of TTP versus HUS alongside traditional scoring.<\/jats:p>","DOI":"10.3390\/jcm11030648","type":"journal-article","created":{"date-parts":[[2022,1,27]],"date-time":"2022-01-27T22:00:56Z","timestamp":1643320856000},"page":"648","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Urine Protein\/Creatinine Ratio in Thrombotic Microangiopathies: A Simple Test to Facilitate Thrombotic Thrombocytopenic Purpura and Hemolytic and Uremic Syndrome Diagnosis"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4292-4490","authenticated-orcid":false,"given":"Laure","family":"Burguet","sequence":"first","affiliation":[{"name":"Service de N\u00e9phrologie Transplantation Dialyse Aph\u00e9r\u00e8ses, Centre de R\u00e9f\u00e9rence Maladies R\u00e9nales Rares du Sud-Ouest, Centre Hospitalier Universitaire de Bordeaux, 33000 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Taton","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie Transplantation Dialyse Aph\u00e9r\u00e8ses, Centre de R\u00e9f\u00e9rence Maladies R\u00e9nales Rares du Sud-Ouest, Centre Hospitalier Universitaire de Bordeaux, 33000 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8302-7783","authenticated-orcid":false,"given":"Mathilde","family":"Prezelin-Reydit","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie Transplantation Dialyse Aph\u00e9r\u00e8ses, Centre de R\u00e9f\u00e9rence Maladies R\u00e9nales Rares du Sud-Ouest, Centre Hospitalier Universitaire de Bordeaux, 33000 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1246-0712","authenticated-orcid":false,"given":"S\u00e9bastien","family":"Rubin","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie Transplantation Dialyse Aph\u00e9r\u00e8ses, Centre de R\u00e9f\u00e9rence Maladies R\u00e9nales Rares du Sud-Ouest, Centre Hospitalier Universitaire de Bordeaux, 33000 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Picard","sequence":"additional","affiliation":[{"name":"Service de R\u00e9animation, Centre Hospitalier de PAU, 64000 Pau, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Gruson","sequence":"additional","affiliation":[{"name":"Service de R\u00e9animation, Centre Hospitalier Universitaire de Bordeaux, 33000 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Ryman","sequence":"additional","affiliation":[{"name":"Laboratoire d\u2019h\u00e9matologie Biologique, Centre Hospitalier Universitaire de Bordeaux, 33000 Bordeaux, France"},{"name":"D\u00e9partement d\u2019h\u00e9matologie et Centre de Reference des Microangiopathies Thrombotiques, H\u00f4pital Saint-Antoine, Assistance Publique des H\u00f4pitaux de Paris and Sorbonne Universit\u00e9s, 75651 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Contin-Bordes","sequence":"additional","affiliation":[{"name":"D\u00e9partement d\u2019h\u00e9matologie et Centre de Reference des Microangiopathies Thrombotiques, H\u00f4pital Saint-Antoine, Assistance Publique des H\u00f4pitaux de Paris and Sorbonne Universit\u00e9s, 75651 Paris, France"},{"name":"Laboratoire d\u2019Immunologie et Immunog\u00e9n\u00e9tique, Centre Hospitalier Universitaire de Bordeaux, 33000 Bordeaux, France"},{"name":"Immunoconcept, CNRS UMR 5164, Universit\u00e9 de Bordeaux, 33076 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Coppo","sequence":"additional","affiliation":[{"name":"D\u00e9partement d\u2019h\u00e9matologie et Centre de Reference des Microangiopathies Thrombotiques, H\u00f4pital Saint-Antoine, Assistance Publique des H\u00f4pitaux de Paris and Sorbonne Universit\u00e9s, 75651 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0360-573X","authenticated-orcid":false,"given":"Christian","family":"Combe","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie Transplantation Dialyse Aph\u00e9r\u00e8ses, Centre de R\u00e9f\u00e9rence Maladies R\u00e9nales Rares du Sud-Ouest, Centre Hospitalier Universitaire de Bordeaux, 33000 Bordeaux, France"},{"name":"Unit\u00e9 INSERM 1026 Biotis, Universit\u00e9 de Bordeaux, 33076 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5814-3122","authenticated-orcid":false,"given":"Yahsou","family":"Delmas","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie Transplantation Dialyse Aph\u00e9r\u00e8ses, Centre de R\u00e9f\u00e9rence Maladies R\u00e9nales Rares du Sud-Ouest, Centre Hospitalier Universitaire de Bordeaux, 33000 Bordeaux, France"},{"name":"D\u00e9partement d\u2019h\u00e9matologie et Centre de Reference des Microangiopathies Thrombotiques, H\u00f4pital Saint-Antoine, Assistance Publique des H\u00f4pitaux de Paris and Sorbonne Universit\u00e9s, 75651 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"17020","DOI":"10.1038\/nrdp.2017.20","article-title":"Thrombotic thrombocytopenic 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CJASN"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/3\/648\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:08:46Z","timestamp":1760134126000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/3\/648"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,27]]},"references-count":26,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["jcm11030648"],"URL":"https:\/\/doi.org\/10.3390\/jcm11030648","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,27]]}}}