Microangiopathic hemolytic anemia
 | This article needs additional citations for verification. (September 2014) |
| Microangiopathic hemolytic anemia | |
|---|---|
| Other names | MAHA |
| Specialty | Hematology |
Microangiopathic hemolytic anemia (MAHA) is a
Signs and symptoms
In diseases such as
Microangiopathic hemolytic anemia may be suspected based on routine medical laboratory tests such as a CBC (complete blood cell count).
Causes
- Disseminated intravascular coagulation
- HELLP syndrome
- Thrombotic thrombocytopenic purpura
- Hemolytic uremic syndrome
- Atypical hemolytic uremic syndrome
- Cancer
- Malignant hypertension
- Scleroderma renal crisis
- Malfunctioning cardiac valves (called the "Waring Blender syndrome")
- Kasabach–Merritt syndrome
- Insertion of foreign bodies
- Drugs (e.g. cancer chemotherapy)
- others diseases: eclampsia, renal allograft rejection, paroxysmal nocturnal hemoglobinuria, scleroderma, and vasculitides such as polyarteritis nodosa and granulomatosis with polyangiitis, antiphospholipid syndrome
Pathophysiology
In all causes, the mechanism of MAHA is the formation of a fibrin mesh due to increased activation of the system of coagulation. The red blood cells are physically cut by these protein networks. The resulting fragments are the schistocytes observed in light microscopy
Diagnosis
Microangiopathic hemolytic anemia results in isolated increase in serum bilirubin levels. Unconjugated hyperbilirubinemia above 15% is present. The differential diagnoses are
Treatment
Platelets and cryoprecipitate are contraindicated as they facilitate further clot formation and RBC lysis. Plasmapheresis is one treatment for TTP; corticosteroids should also be considered. {mcn}
References
- S2CID 22880281.
- PMID 27795225.
- ^ "Harrison's Principles of Internal Medicine, 19th Edition Textbook". www.harrisonsim.com. Retrieved 14 January 2018.
- ISBN 978-0-323-53113-9.