Schema for ๐Thrombotic Microangiopathies (TMAs)๐
How do you arrive here?
(1/x)
How do you arrive here?
(1/x)
Unexplained anemia + thrombocytopenia
๐
(+) hemolysis labs & (โ) Direct antiglobulin test (ie DAT)
๐
Smear w/ schistocytes! This is supportive of microangiopathic hemolytic anemia (MAHA).
See @MatthewHoMD's hemolytic anemia journey:
(2/x)
๐
(+) hemolysis labs & (โ) Direct antiglobulin test (ie DAT)
๐
Smear w/ schistocytes! This is supportive of microangiopathic hemolytic anemia (MAHA).
See @MatthewHoMD's hemolytic anemia journey:
(2/x)
๐ Pearl 1: also consider patient's history/exam, as mechanical heart valves can cause MACROangiopathic hemolytic anemia.
๐ Pearl 2: not all MAHA (non-immune hemolysis 2/2 RBC fragmentation) is caused by a TMA, but nearly all TMAs cause MAHA & thrombocytopenia.
(3/x)
๐ Pearl 2: not all MAHA (non-immune hemolysis 2/2 RBC fragmentation) is caused by a TMA, but nearly all TMAs cause MAHA & thrombocytopenia.
(3/x)
๐ Primary TMAs:
- TTP
- Shiga toxin-mediated HUS
aHUS:
- Complement-mediated TMA
- Drug-induced TMA
- Rare hereditary disorders of B12 metabolism or Coagulation
๐ Pearl 3: "atypical HUS" refers to any TMA w/o severe ADAMTS13 deficiency or Shiga-toxin (non-specific!)
(4/x)
- TTP
- Shiga toxin-mediated HUS
aHUS:
- Complement-mediated TMA
- Drug-induced TMA
- Rare hereditary disorders of B12 metabolism or Coagulation
๐ Pearl 3: "atypical HUS" refers to any TMA w/o severe ADAMTS13 deficiency or Shiga-toxin (non-specific!)
(4/x)
๐ Secondary TMAs:
- HELLP & Malignant HTN
- Systemic Infections, Malignancies, & Autoimmune disorders
- Bone marrow / Solid organ transplant-related TMA
(5/x)
- HELLP & Malignant HTN
- Systemic Infections, Malignancies, & Autoimmune disorders
- Bone marrow / Solid organ transplant-related TMA
(5/x)
On work-up & management of TMA here:
(7/x)
(7/x)
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