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Thrombotic microangiopathies: An illustrated review

2022; Elsevier BV; Volume: 6; Issue: 3 Linguagem: Inglês

10.1002/rth2.12708

2475-0379

Mouhamed Yazan Abou‐Ismail, Sargam Kapoor, Divyaswathi Citla Sridhar, Lalitha Nayak, Sanjay Ahuja,

Renal Transplantation Outcomes and Treatments

Research and Practice in Thrombosis and HaemostasisVolume 6, Issue 3 e12708 ILLUSTRATED REVIEWOpen Access Thrombotic microangiopathies: An illustrated review Mouhamed Yazan Abou-Ismail MD, Corresponding Author Mouhamed Yazan Abou-Ismail MD yazan.abou-ismail@hsc.utah.edu @DoctorYazanA orcid.org/0000-0002-6682-4366 Division of Hematology and Hematologic Malignancies, Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah, USA Correspondence Mouhamed Yazan Abou-Ismail, 30 N 1900 E, RM 1B390, Salt Lake City, UT 84112, USA. Email: yazan.abou-ismail@hsc.utah.eduSearch for more papers by this authorSargam Kapoor MD, Sargam Kapoor MD Department of Hematology & Oncology, Alaska Native Medical Center, Anchorage, Alaska, USASearch for more papers by this authorDivyaswathi Citla Sridhar MD, Divyaswathi Citla Sridhar MD @DivyaCitlaMD orcid.org/0000-0002-7569-3118 Department of Pediatric Hematology & Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USASearch for more papers by this authorLalitha Nayak MD, Lalitha Nayak MD @nayaklalitha1 orcid.org/0000-0002-9534-3502 Department of Hematology & Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USASearch for more papers by this authorSanjay Ahuja MD, MSc, Sanjay Ahuja MD, MSc @ahujadoc orcid.org/0000-0002-0178-7947 Department of Pediatric Hematology & Oncology, University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, Ohio, USASearch for more papers by this author Mouhamed Yazan Abou-Ismail MD, Corresponding Author Mouhamed Yazan Abou-Ismail MD yazan.abou-ismail@hsc.utah.edu @DoctorYazanA orcid.org/0000-0002-6682-4366 Division of Hematology and Hematologic Malignancies, Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah, USA Correspondence Mouhamed Yazan Abou-Ismail, 30 N 1900 E, RM 1B390, Salt Lake City, UT 84112, USA. Email: yazan.abou-ismail@hsc.utah.eduSearch for more papers by this authorSargam Kapoor MD, Sargam Kapoor MD Department of Hematology & Oncology, Alaska Native Medical Center, Anchorage, Alaska, USASearch for more papers by this authorDivyaswathi Citla Sridhar MD, Divyaswathi Citla Sridhar MD @DivyaCitlaMD orcid.org/0000-0002-7569-3118 Department of Pediatric Hematology & Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USASearch for more papers by this authorLalitha Nayak MD, Lalitha Nayak MD @nayaklalitha1 orcid.org/0000-0002-9534-3502 Department of Hematology & Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USASearch for more papers by this authorSanjay Ahuja MD, MSc, Sanjay Ahuja MD, MSc @ahujadoc orcid.org/0000-0002-0178-7947 Department of Pediatric Hematology & Oncology, University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, Ohio, USASearch for more papers by this author First published: 22 April 2022 https://doi.org/10.1002/rth2.12708 Handling Editor: Dr Michelle Sholzberg Funding information: This work did not receive any funding. AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract The thrombotic microangiopathies (TMAs) are a heterogenous group of disorders with distinct pathophysiologies that cause occlusive microvascular or macrovascular thrombosis, and are characterized by microangiopathic hemolytic anemia, thrombocytopenia, and/or end-organ ischemia. TMAs are associated with significant morbidity and mortality, and data on the management of certain TMAs are often lacking. The nomenclature, classification, and management of various TMAs is constantly evolving as we learn more about these rare syndromes. Thorough clinical and laboratory evaluation is essential to distinguish various TMAs and arrive at an accurate diagnosis, which is key for appropriate management. In this illustrated review, we focus on thrombotic thrombocytopenic purpura (TTP), Shiga toxin–associated hemolytic uremic syndrome, complement-mediated hemolytic uremic syndrome, hematopoietic cell transplant-associated TMA, and drug-induced TMA, and describe their incidence, pathophysiology, diagnosis, and management. We also highlight emerging complement-directed therapies under investigation for the management of complement-mediated TMAs. Essentials Thrombotic microangiopathies (TMAs) are a diverse group of rare, life-threatening disorders. We review the incidence, pathophysiology, evaluation, and management of various TMAs. 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