Immune Thrombotic Thrombocytopenic Purpura in Elderly Patients; the Role for PLASMIC and French Scores
Makaleler > Tam Makale · 2023
Yazarlar: Mehmet Baysal, Fehmi Hindilerden, Elif Gülsüm Ümit, Ahmet Muzaffer Demir, Fatma KEKLİK KARADAĞ, Güray SAYDAM, Seval Akpınar, Burhan Turgut, Vildan Özkocaman, Fahir Ozkalemkaş, Rafiye Çiftçiler, Can Özlü, Sinan Demircioğlu, Yıldız Ipek, Reyhan Diz Küçükkaya
Turkish Journal of Hematology, Uluslararası, Wos, 2023, cilt 40, ss 251-257
DOI: 10.4274/tjh.galenos.2023.2023-0295
Özet
Objective: In recent years, new developments have been incorporated into daily practice in the management of immune thrombotic thrombocytopenic purpura (iTTP).In particular, clinical scoring systems could help clinicians with clinical decision-making and early recognition.However, older patients frequently present with more organ involvement and in unusual ways.The ways in which age could affect these clinical prediction scoring systems remain unclear.We evaluated the use of PLASMIC and French scores in patients over 60 years of age. Materials and Methods:We performed a retrospective crosssectional analysis of patients over 60 years of age with a presumptive diagnosis of iTTP between 2014 and 2022 at 10 centers.We calculated PLASMIC and French scores and compared our data with a singlecenter analysis of younger patients presenting with thrombotic microangiopathy.Results: Our study included 30 patients over 60 years of age and a control group of 28 patients younger than 60 years.The diagnostic sensitivity and specificity of a French score of ≥1 were lower in older patients compared to the control group (78.9% vs. 100% and 18.2% vs. 57.1%,respectively).The diagnostic sensitivity and specificity of a PLASMIC score of ≥5 were 100% vs. 95% and 27.3% vs. 100% for the study group and control group, respectively.Our study showed a Amaç: Son yıllarda, immün trombotik trombositopenik purpura (iTTP) yönetiminde günlük uygulamalara yeni gelişmeler eklenmiştir.Özellikle klinik skorlama sistemleri klinisyenlere klinik karar verme ve erken tanıda yardımcı olabilir.Ancak, yaşlı hastalar genellikle daha fazla organ tutulumu ve alışılmadık şekillerde başvurabilmektedir.İleri yaşın bu klinik tahmin skorlama sistemleri üzerindeki etkisi belirsizdir.Bu bağlamda, PLASMIC ve French skorlarının 60 yaş ve üzeri hastalarda kullanılabilirliğini değerlendirdik.Gereç ve Yöntemler: 2014 ile 2022 yılları arasında on merkezde iTTP olası tanısı alan 60 yaş üstü hastalar retrospektif olarak değerlendirildi.PLASMIC ve French skorlarını hesapladık ve verilerimizi trombotik mikroanjiyopati ile başvuran genç hastaların tek merkezli analiziyle karşılaştırdık.