To Determine Diagnosis
To establish MAHA diagnosis - based upon history, examination and laboratory picture:
- FBC
- Blood film
- Reticulocyte count
- LDH and bilirubin
- Coagulation including fibrinogen
- Coombs test (Direct Antiglobulin Test)
- Urinalysis
Definitive testing:
If suspected, do not wait to treat!
If suspected, do not wait to treat!
- ADAMTS13 activity
- Anti-ADAMTS13 Ab
- Sequencing of ADAMTS13 gene
To Determine Aetiology
- Pregnancy test
- Virology screen - before PLEX:
- HIV
- HBV / HCV
- CMV
- Autoimmune screen (assess for SLE / APL):
- ANA / ACA / RF Lupus anticoagulant
- Thyroid Function Tests (for Graves)
- If diarrhoea: stool culture for e.coli
To Assess for Complications
Determine organ involvement:
- Renal function tests and urinalysis
- ECG and troponin
- CT / MRI Brain
- Amylase
To Exclude Differentials