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Thrombotic microangiopathies - hemolytic-uremic syndromes and thrombotic thrombocytopenic purpura

Publication at Second Faculty of Medicine |
2017

Abstract

Thrombotic microangiopathies are a heterogeneous group of disease that causes damage of endothelial cells of small arteries in different organs that lead to thrombi formation and organ ischemia. The laboratory markers of TMA are typically a triad of non-immune hemolytic anemia, thrombocytopenia and acute kidney injury.

Thrombotic microangiopathies could be differentiated according their etiology to hemolytic-uremic syndromes (HUS) - typical HUS (caused by Shiga-toxin producing E. coli) and atypical HUS (aHUS, caused mainly by dysregulation of alternative pathway of complement) and thrombotic thrombocytopenic purpura (TTP, severe deficiency of von Willebrand factor cleaving protease called ADAMTS13). Treatment of TMA depend on its etiology - only symptomatic therapy in typical HUS (dialysis, transfusion), plasmapheresis, immunosuppression or plasma infusions in TTP and monoclonal anti-C5 antibody eculizumab in aHUS.