Journal
AMERICAN JOURNAL OF CLINICAL PATHOLOGY
Volume 145, Issue 2, Pages 158-165Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/ajcp/aqv086
Keywords
Thrombotic microangiopathy (TMA); Thrombotic thrombocytopenic purpura (TTP); Hemolytic uremic syndrome (HUS); Microangiopathic hemolytic anemia (MAHA)
Categories
Ask authors/readers for more resources
Objectives: Pathologists specializing in transfusion medicine, apheresis medicine, and/or coagulation are often consulted by clinicians to reach a diagnosis for patients with thrombotic microangiopathy (TMA), so that disease-specc, often life-saving therapy can be initiated as promptly as possible. Methods: This article describes how to proceed when treating a patient with TMA. The differential diagnosis is broad and potentially very challenging. Thrombotic thrombocytopenic purpura (TTP), atypical hemolytic uremic syndrome (aHUS), and typical hemolytic uremic syndrome (HUS) are three such TMAs that require timely diagnosis and treatment. Results: TTP is treated with daily therapeutic plasma exchange (TPE) and commonly with adjunctive immunosuppressive therapy, while aHUS may initially be managed with TPE but is best controlled with eculizumab once a presumptive diagnosis is made. TPE has no proven role in typical HUS, which is most commonly treated with supportive measures only. Conclusions: Prompt and accurate diagnosis of TMA sub-types optimizes treatment and improves patient outcomes.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available