What are the limitations of the plasmic score?

While the plasmic score is highly validated, it should not replace clinical judgment. OpiCalc provides the latest evidence-based limitations for the plasmic score to ensure safe bedside use and optimal diagnostic accuracy.

How does the plasmic score compare to other Hematology scores?

The plasmic score is a gold-standard diagnostic tool. OpiCalc provides side-by-side clinical guidance to help clinicians choose the most specific evidence-based tool for their patient's presentation.

Is the plasmic score free to use?

Yes. OpiCalc provides the plasmic score completely ad-free and optimized for mobile bedside use, ensuring you can calculate medical risk swiftly and without distraction.

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PLASMIC Score

TTP Emergency: ADAMTS13 turnaround is slow. The PLASMIC score predicts severe deficiency with high accuracy, enabling life-saving treatment initiation based on bedside lab variables.

Clinical & Lab Predictors

PLASMIC Score

0

Probability Class

Low Risk

~0 - 4% ADAMTS13 deficiency likelihood

Clinical Directive

Search for alternative TMA

Evidence Based Triage

Guidelines & Evidence

Clinical Details

Section 1

When to Use

Evaluating patients with suspected Thrombotic Thrombocytopenic Purpura (TTP).

Predicting the likelihood of severe ADAMTS13 deficiency (< 10%).

Determining the urgency for plasma exchange (PEX) while awaiting ADAMTS13 turnaround.

The Emergency Triage

TTP is a medical emergency with nearly 90% mortality if untreated. The PLASMIC score allows for immediate clinical decisions when ADAMTS13 results are not rapidly available.

Section 2

Formula & Logic

Predictors (1 point each)

Platelet count < 30 × 10⁹/L.

Evidence of Hemolysis (Reticulocyte count > 2.5%, haptoglobin low, or indirect bilirubin > 2 mg/dL).

No active cancer (treatment within 12 months).

No solid organ or stem cell transplant.

MCV < 90 fL.

INR < 1.5.

Creatinine < 2.0 mg/dL (177 µmol/L).

Interpretation

Score	Risk Class	Likelihood of severe ADAMTS13 deficiency
0 - 4	Low Risk	0 - 4%
5	Intermediate	5 - 24%
6 - 7	High Risk	62 - 82%

Section 3

Pearls/Pitfalls

TTP vs. HUS

The inclusion of Creatinine < 2.0 and Platelet < 30 helps differentiate TTP from HUS, where renal failure is usually more severe and thrombocytopenia less pronounced.

Management Action

Patients with a High Risk PLASMIC score (6–7) should start therapeutic Plasma Exchange (PEX) and high-dose steroids immediately. Do not delay for ADAMTS13 results.

Section 4

Evidence Appraisal

Primary Strategy

Derivation and external validation of the PLASMIC score for rapid assessment of adults with suspected hemolytic uremic syndrome and thrombotic thrombocytopenic purpura.

Bendapudi PK et al. • The Lancet Haematology. 2017;4(4):e157-e164.

View Source

Section 5

Literature

Validation

Developed based on the Harvard TMA Research Collaborative and validated in multiple large-scale external cohorts.

Last Comprehensive Review: 2026

Guidelines & Evidence

Clinical Details

Section 1

When to Use

Evaluating patients with suspected Thrombotic Thrombocytopenic Purpura (TTP).

Predicting the likelihood of severe ADAMTS13 deficiency (< 10%).

Determining the urgency for plasma exchange (PEX) while awaiting ADAMTS13 turnaround.

The Emergency Triage

TTP is a medical emergency with nearly 90% mortality if untreated. The PLASMIC score allows for immediate clinical decisions when ADAMTS13 results are not rapidly available.

Section 2

Formula & Logic

Predictors (1 point each)

Platelet count < 30 × 10⁹/L.

Evidence of Hemolysis (Reticulocyte count > 2.5%, haptoglobin low, or indirect bilirubin > 2 mg/dL).

No active cancer (treatment within 12 months).

No solid organ or stem cell transplant.

MCV < 90 fL.

INR < 1.5.

Creatinine < 2.0 mg/dL (177 µmol/L).

Interpretation

Score	Risk Class	Likelihood of severe ADAMTS13 deficiency
0 - 4	Low Risk	0 - 4%
5	Intermediate	5 - 24%
6 - 7	High Risk	62 - 82%

Section 3

Pearls/Pitfalls

TTP vs. HUS

The inclusion of Creatinine < 2.0 and Platelet < 30 helps differentiate TTP from HUS, where renal failure is usually more severe and thrombocytopenia less pronounced.

Management Action

Patients with a High Risk PLASMIC score (6–7) should start therapeutic Plasma Exchange (PEX) and high-dose steroids immediately. Do not delay for ADAMTS13 results.

Section 4

Evidence Appraisal

Primary Strategy

Derivation and external validation of the PLASMIC score for rapid assessment of adults with suspected hemolytic uremic syndrome and thrombotic thrombocytopenic purpura.

Bendapudi PK et al. • The Lancet Haematology. 2017;4(4):e157-e164.

View Source

Section 5

Literature

Validation

Developed based on the Harvard TMA Research Collaborative and validated in multiple large-scale external cohorts.

Last Comprehensive Review: 2026

Related Hematology Tools

Mentzer Index

England & Fraser Index

Shine & Lal Index

Corrected Reticulocyte Count

Transferrin Saturation Calculator

Iron Deficit Calculator

HFE Haemochromatosis Risk Estimator

Hepatic Iron Index

DAT Interpretation Algorithm

Coombs-Negative Haemolysis Checklist

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PLASMIC Score

TTP Emergency: ADAMTS13 turnaround is slow. The PLASMIC score predicts severe deficiency with high accuracy, enabling life-saving treatment initiation based on bedside lab variables.

Clinical & Lab Predictors

PLASMIC Score

0

Probability Class

Low Risk

~0 - 4% ADAMTS13 deficiency likelihood

Clinical Directive

Search for alternative TMA

Evidence Based Triage

Guidelines & Evidence

Clinical Details

Section 1

When to Use

Evaluating patients with suspected Thrombotic Thrombocytopenic Purpura (TTP).

Predicting the likelihood of severe ADAMTS13 deficiency (< 10%).

Determining the urgency for plasma exchange (PEX) while awaiting ADAMTS13 turnaround.

The Emergency Triage

TTP is a medical emergency with nearly 90% mortality if untreated. The PLASMIC score allows for immediate clinical decisions when ADAMTS13 results are not rapidly available.

Section 2

Formula & Logic

Predictors (1 point each)

Platelet count < 30 × 10⁹/L.

Evidence of Hemolysis (Reticulocyte count > 2.5%, haptoglobin low, or indirect bilirubin > 2 mg/dL).

No active cancer (treatment within 12 months).

No solid organ or stem cell transplant.

MCV < 90 fL.

INR < 1.5.

Creatinine < 2.0 mg/dL (177 µmol/L).

Interpretation

Score	Risk Class	Likelihood of severe ADAMTS13 deficiency
0 - 4	Low Risk	0 - 4%
5	Intermediate	5 - 24%
6 - 7	High Risk	62 - 82%

Section 3

Pearls/Pitfalls

TTP vs. HUS

The inclusion of Creatinine < 2.0 and Platelet < 30 helps differentiate TTP from HUS, where renal failure is usually more severe and thrombocytopenia less pronounced.

Management Action

Patients with a High Risk PLASMIC score (6–7) should start therapeutic Plasma Exchange (PEX) and high-dose steroids immediately. Do not delay for ADAMTS13 results.

Section 4

Evidence Appraisal

Primary Strategy

Derivation and external validation of the PLASMIC score for rapid assessment of adults with suspected hemolytic uremic syndrome and thrombotic thrombocytopenic purpura.

Bendapudi PK et al. • The Lancet Haematology. 2017;4(4):e157-e164.

View Source

Section 5

Literature

Validation

Developed based on the Harvard TMA Research Collaborative and validated in multiple large-scale external cohorts.

Last Comprehensive Review: 2026

Guidelines & Evidence

Clinical Details

Section 1

When to Use

Evaluating patients with suspected Thrombotic Thrombocytopenic Purpura (TTP).

Predicting the likelihood of severe ADAMTS13 deficiency (< 10%).

Determining the urgency for plasma exchange (PEX) while awaiting ADAMTS13 turnaround.

The Emergency Triage

TTP is a medical emergency with nearly 90% mortality if untreated. The PLASMIC score allows for immediate clinical decisions when ADAMTS13 results are not rapidly available.

Section 2

Formula & Logic

Predictors (1 point each)

Platelet count < 30 × 10⁹/L.

Evidence of Hemolysis (Reticulocyte count > 2.5%, haptoglobin low, or indirect bilirubin > 2 mg/dL).

No active cancer (treatment within 12 months).

No solid organ or stem cell transplant.

MCV < 90 fL.

INR < 1.5.

Creatinine < 2.0 mg/dL (177 µmol/L).

Interpretation

Score	Risk Class	Likelihood of severe ADAMTS13 deficiency
0 - 4	Low Risk	0 - 4%
5	Intermediate	5 - 24%
6 - 7	High Risk	62 - 82%

Section 3

Pearls/Pitfalls

TTP vs. HUS

The inclusion of Creatinine < 2.0 and Platelet < 30 helps differentiate TTP from HUS, where renal failure is usually more severe and thrombocytopenia less pronounced.

Management Action

Patients with a High Risk PLASMIC score (6–7) should start therapeutic Plasma Exchange (PEX) and high-dose steroids immediately. Do not delay for ADAMTS13 results.

Section 4