The evaluation of a scoring system for diagnosing atypical hemolytic uremic syndrome

Objective: Although the definitive diagnosis of atypical hemolytic uremic syndrome (aHUS) depends on a genetic analysis for the complement factors, such a genetic analysis is time-consuming and expensive. We examined the usefulness of a diagnostic scoring system for aHUS. Methods: The thrombotic mic...

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Bibliographic Details
Main Authors: Hideo Wada, Katsuya Shiraki, Takeshi Matsumoto, Hideto Shimpo, Yoshiki Yamashita, Motomu Shimaoka
Format: Article
Language:English
Published: Elsevier 2020-12-01
Series:Thrombosis Update
Subjects:
TMA
TTP
Online Access:http://www.sciencedirect.com/science/article/pii/S2666572720300122
Description
Summary:Objective: Although the definitive diagnosis of atypical hemolytic uremic syndrome (aHUS) depends on a genetic analysis for the complement factors, such a genetic analysis is time-consuming and expensive. We examined the usefulness of a diagnostic scoring system for aHUS. Methods: The thrombotic microangiopathy (TMA) scoring system consists of hemoglobin, the platelet count, creatinine levels and organ failure, and the aHUS scoring system consists of past history and family history of TMA, age at onset, prodromal symptoms and “red or brownish urine”, and these scoring system were both evaluated in patients with aHUS, thrombotic thrombocytopenic purpura or secondary TMA. Results: In a receiver operating characteristics analysis, an adequate cut-off value for diagnosing aHUS, TTP, other TMA or all TMA versus patients without TMA was 7 points for both TMA screening scores. The area under the curve was 0.965 for the TMA screening score and 0.966 for the aHUS score. An adequate cut-off value for diagnosing aHUS was 2 points for a positive aHUS score, - 3 points for an exclusion aHUS score and 0 points for the total aHUS score. Conclusion: The TMA screening and aHUS score systems are useful for making a diagnosis of aHUS without performing specific laboratory tests.
ISSN:2666-5727