Thrombotic_Microangiopathy

Thrombotic_Microangiopathy - THROMBOTIC MICROANGIOPATHY...

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THROMBOTIC MICROANGIOPATHY Jun-Ki Park 7/19/11
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TMA is a descriptive name for the histologic abnormalities: - Thrombi in the glomeruli and arterioles. - EM: subendothelial widening of the glomerular capillary wall due to the deposition of fibrin-like material. - During healing, mucoid intimal thickening and then ‘onion-skin’ hypertrophy of the interlobular arteries. TMAs are microvascular occlusive disorders characterized by systemic or intrarenal aggregation of platelets, thrombocytopenia, and mechanical injury to erythrocytes.
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In addition to TTP and HUS, TMA may occur in other disorders, such as: - malignant HTN - scleroderma - anti-phopholipid antibody syndrome -SLE - preeclampsia - radiation nephropathy - renal allograft rejection - HIV infection - allogenic HSCT - disseminated malignancy
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History Thrombotic thrombocytopenic purpura (TTP) Moschowitz described in 1924 as a new disease characterized by unique pathological findings of hyaline thrombi in many organs. Amorosi and Ultmann defined in 1964 the classic clinical features: - Thrombocytopenia - MAHA - neurologic symptoms - renal dysfunction - fever Hemolytic-uremic syndrome (HUS) First described by Gasser et al. in 1955 in a report of five children with acute renal failure who died with renal cortical necrosis. Current childhood HUS is a different disorder, noticed since 1980 with the appearance of Shiga toxin-producing Escherichia coli (usually E. coli O157:H7, most recent outbreak of O104:H4 )
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Incidence D. R. TERRELL et al. Journal of Thrombosis and Haemostasis, 3: 1432–1436, 2005
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For the 206 patients with an initial episode of clinically suspected TTP-HUS in whom the decision to initiate plasma exchange treatment was made, the clinical setting in which these patients presented included the following: Idiopathic —
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Thrombotic_Microangiopathy - THROMBOTIC MICROANGIOPATHY...

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