Thrombotic Microangiopathies (TMAs)
Thrombotic Microangiopathies (TMAs): Understanding the Condition
Thrombotic Microangiopathies (TMAs) are pathological conditions characterized by thrombosis in capillaries and arterioles due to endothelial injury1. This leads to microangiopathic hemolytic anemia, thrombocytopenia, and ischemic tissue injury4. TMAs are rare but life-threatening and require urgent management47.
Signs and Symptoms
The clinical presentation of TMA can vary but typically includes123:
- Thrombocytopenia245
- Microangiopathic hemolytic anemia (MAHA), with schistocytes in a blood smear124
- Organ dysfunction, affecting the brain, kidneys, heart, pancreas, liver, lungs, eyes, and skin25
Other symptoms, depending on the type of TMA, may include123:
- Fever13
- Weakness and fatigue238
- Confusion, seizures, or headaches23
- Decreased urine output, swollen legs, or high blood pressure3
- Bruising, gum/nose bleeds, or heavy bleeding from minor cuts3
Causes of TMA
Several conditions can lead to TMA, including16:
- Classic TMAs: Hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP)1
- Other Conditions: Atypical hemolytic uremic syndrome (aHUS), disseminated intravascular coagulation (DIC), scleroderma renal crisis, malignant hypertension, antiphospholipid antibody syndrome, and drug toxicities1
- Infections: Shiga toxin-producing Escherichia coli (STEC-HUS)6
- Systemic Diseases: Autoimmune diseases, severe hypertension, solid malignancies, hematologic malignancies, certain medications, pregnancy-related conditions, and organ/bone marrow transplantation6
- Complement-mediated TMA: Genetic abnormalities in complement proteins6
Diagnosis
Diagnosis involves identifying clinical symptoms and conducting laboratory tests46:
- Blood Tests: Complete blood count to check for thrombocytopenia and anemia, and a blood smear to look for schistocytes4
- ADAMTS13 Testing: To measure ADAMTS13 activity, with levels <10% indicating TTP6
- Infection Screening: Stool toxin and viral serology testing6
- Autoimmune Screening: To identify systemic diseases6
- Complement Testing: Genetic or functional assays for complement-mediated TMA6
Treatment
Treatment strategies vary depending on the underlying cause of TMA56:
- TTP: Plasma exchange46
- aHUS: Complement inhibitors like eculizumab6
- Infection-associated TMA: Addressing the underlying infection6
- Supportive Care: Managing symptoms and preventing complications6
Consult with Our Team of Experts Now!
At DrStemCellsThailand (DRSCT)‘s Anti-Aging and Regenerative Medicine Center of Thailand, we emphasize comprehensive evaluations and personalized treatment plans of Cellular Therapy and Stem Cells for managing various health conditions. If you have questions about Thrombotic Microangiopathies (TMAs) or would like more information on our services related to hematology or nephrology, consult with our experts today!
