Abstract Number: PB1888
Meeting: ISTH 2020 Congress
Background: Rapid diagnosis of thrombotic thrombocytopenic purpura (TTP) is important because untreated mortality is 90%, which can be reduced with prompt plasma exchange (PEX). A severely reduced ADAMTS-13 activity of < 10 IU/dL (< 10 %) confirms TTP diagnosis. Without a rapid ADAMTS-13 activity assay, some cases of possible TTP may have inappropriate PEX administered. A reliable ADAMTS-13 activity result is also needed to diagnose atypical HUS (aHUS).
Aims: To compare a rapid, automated quantitative chemiluminescent assay (HemosIL® ADAMTS-13 Activity, Instrumentation Laboratory) to a commercially available ADAMTS-13 activity ELISA (Technozym® ADAMTS-13 Activity, Technoclone).
Methods: Frozen citrated plasma samples (n=205) from patients with possible TTP were analysed using both methods. Based on ELISA results, there were 59 samples with ADAMTS-13 activity < 10 IU/dL, 76 with ELISA results 10-40 IU/dL and 70 with ELISA results > 40 IU/dL.
Results: Correlation between the two methods was 0.929. The mean sample results was 32 IU/dL and 37 IU/dL (p < 0.0001) for ELISA and AcuStar, respectively. All 59 samples with ELISA results < 10 IU/dL also had AcuStar < 10 IU/dL. Amongst the 76 samples with ELISA results 10-40 IU/dL, 4 samples (ELISA results 10.8, 10.9, 10.9 and 24.9 IU/dL) had AcuStar results of 5-10 IU/dL.These differences would not have impacted on patient management. No samples with ELISA >40 IU/dL had AcuStar results < 22 IU/dL. Analysis time with the HemosIL ADAMTS-13 Activity assay on the AcuStar is < 40 minutes giving a turnaround time from receipt of sample to issue of result of < 1 hour with AcuStar compared to 4 hours for ELISA.
Conclusions: The rapid, automated chemiluminescent HemosIL AcuStar ADAMTS-13 activity assay is suitable for routine use. The technical simplicity and assay time < 40 minutes has led to the introduction of a 24/7 on-demand ADAMTS-13 activity service in our centre.
[ADAMTS-13 activity comparison data]
To cite this abstract in AMA style:Fretwell RE, Pitchford T, Cooper S, Kitchen S. Evaluation of a Rapid, Automated Chemiluminescent ADAMTS-13 Activity Assay for the ACL AcuStar [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/evaluation-of-a-rapid-automated-chemiluminescent-adamts-13-activity-assay-for-the-acl-acustar/. Accessed January 21, 2022.
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