thrombma
Table of Contents
thrombotic microangiopathy (TMA)
see also:
Introduction
- thrombotic microangiopathy is an uncommon condition which may cause life threatening acute kidney injury (AKI) / acute renal failure (ARF) requiring dialysis
Clinical features
- intravascular haemolysis on the blood film
- raised creatinine level with or without acute kidney injury (AKI) / acute renal failure (ARF)
Aetiology
- pregnancy-related conditions (HELLP syndrome in pregnancy )
- malignant hypertension
- toxins:
- direct endothelial toxins (avastin, calcineurin inhibitors)
- infections
- malignancies
- scleroderma
- immune-mediated reactions to medications
- oxaliplatin
- gemcitabine
- sulfasoxazole
- other autoimmune conditions
Differential diagnosis
Diagnosis
- exclude thrombotic thrombocytopenic purpura (TTP) by finding adequate ADAMTS-13 levels
- exclude complement-mediated haemolytic uraemic syndrome (HUS) by finding normal serum C3 levels (although some cases of complement-HUS do have normal serum C3 levels) - this condition may need very expensive life-long Rx with eculizumab
- search for causes of TMA
- eg. quinine antibodies
thrombma.txt · Last modified: 2023/09/08 09:53 by gary1