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Microangiopathic hemolytic anemia

MedGen UID:
65120
Concept ID:
C0221021
Disease or Syndrome
Synonyms: Anemia, Microangiopathic Hemolytic; Hemolytic Anemia, Microangiopathic; Microangiopathic Hemolytic Anemia; Microangiopathic Hemolytic Anemias
SNOMED CT: MAHA - Microangiopathic hemolytic anemia (51071000); MHA - Microangiopathic hemolytic anemia (51071000); Microangiopathic hemolytic anemia (51071000); Shunt hyperbilirubinemia (51071000); Israel's shunt hyperbilirubinemia (51071000)
 
HPO: HP:0001937

Definition

Acquired anemia due to destruction of red blood cells by physical trauma such as FIBRIN strands in the blood vessels, artificial heart valve, AORTIC COARCTATION. I can also be associated with hematologic diseases such as DISSEMINATED INTRAVASCULAR COAGULATION; HEMOLYTIC-UREMIC SYNDROME; and THROMBOTIC THROMBOCYTOPENIC PURPURA. [from MeSH]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVMicroangiopathic hemolytic anemia

Conditions with this feature

Kasabach-Merritt syndrome
MedGen UID:
65122
Concept ID:
C0221025
Disease or Syndrome
Although cutaneous hemangiomas are common benign tumors in neonates, they can be life-threatening when they are associated with thrombocytopenia, consumptive coagulopathy, microangiopathic hemolytic anemia, and rapid enlargement, a clinical presentation known as Kasabach-Merritt syndrome (KMS). Untreated, KMS has a 10 to 37% mortality rate (Szlachetka, 1998). With giant hemangiomas in small children, thrombocytopenia and red cell changes compatible with trauma ('microangiopathic hemolytic anemia') have been observed. The mechanism of the hematologic changes is obscure. No evidence of a simple genetic basis has been discovered. Reviews Szlachetka (1998) reviewed the approximately 205 reported cases of KMS and discussed the pathophysiology, clinical manifestations, differential diagnosis, and treatment modalities of the disorder.
Upshaw-Schulman syndrome
MedGen UID:
224783
Concept ID:
C1268935
Disease or Syndrome
Hereditary thrombotic thrombocytopenic purpura (TTP), also known as Upshaw-Schulman syndrome (USS), is a rare autosomal recessive thrombotic microangiopathy (TMA). Clinically, acute phases of TTP are defined by microangiopathic mechanical hemolytic anemia, severe thrombocytopenia, and visceral ischemia. Hereditary TTP makes up 5% of TTP cases and is caused mostly by biallelic mutation in the ADAMTS13 gene, or in very rare cases, by monoallelic ADAMTS13 mutation associated with a cluster of single-nucleotide polymorphisms (SNPs); most cases of all TTP (95%) are acquired via an autoimmune mechanism (see 188030). Hereditary TTP is more frequent among child-onset TTP compared with adult-onset TTP, and its clinical presentation is significantly different as a function of its age of onset. Child-onset TTP usually starts in the neonatal period with hematological features and severe jaundice. In contrast, almost all cases of adult-onset hereditary TTP are unmasked during the first pregnancy of a woman whose disease was silent during childhood (summary by Joly et al., 2018).
Hemolytic uremic syndrome, atypical, susceptibility to, 1
MedGen UID:
412743
Concept ID:
C2749604
Finding
Hemolytic-uremic syndrome (HUS) is characterized by hemolytic anemia, thrombocytopenia, and renal failure caused by platelet thrombi in the microcirculation of the kidney and other organs. The onset of atypical HUS (aHUS) ranges from the neonatal period to adulthood. Genetic aHUS accounts for an estimated 60% of all aHUS. Individuals with genetic aHUS frequently experience relapse even after complete recovery following the presenting episode; 60% of genetic aHUS progresses to end-stage renal disease (ESRD).
Atypical hemolytic-uremic syndrome with thrombomodulin anomaly
MedGen UID:
414541
Concept ID:
C2752036
Finding
Hemolytic-uremic syndrome (HUS) is characterized by hemolytic anemia, thrombocytopenia, and renal failure caused by platelet thrombi in the microcirculation of the kidney and other organs. The onset of atypical HUS (aHUS) ranges from the neonatal period to adulthood. Genetic aHUS accounts for an estimated 60% of all aHUS. Individuals with genetic aHUS frequently experience relapse even after complete recovery following the presenting episode; 60% of genetic aHUS progresses to end-stage renal disease (ESRD).
Atypical hemolytic-uremic syndrome with C3 anomaly
MedGen UID:
442875
Concept ID:
C2752037
Finding
Hemolytic-uremic syndrome (HUS) is characterized by hemolytic anemia, thrombocytopenia, and renal failure caused by platelet thrombi in the microcirculation of the kidney and other organs. The onset of atypical HUS (aHUS) ranges from the neonatal period to adulthood. Genetic aHUS accounts for an estimated 60% of all aHUS. Individuals with genetic aHUS frequently experience relapse even after complete recovery following the presenting episode; 60% of genetic aHUS progresses to end-stage renal disease (ESRD).
Atypical hemolytic-uremic syndrome with B factor anomaly
MedGen UID:
416691
Concept ID:
C2752038
Finding
Hemolytic-uremic syndrome (HUS) is characterized by hemolytic anemia, thrombocytopenia, and renal failure caused by platelet thrombi in the microcirculation of the kidney and other organs. The onset of atypical HUS (aHUS) ranges from the neonatal period to adulthood. Genetic aHUS accounts for an estimated 60% of all aHUS. Individuals with genetic aHUS frequently experience relapse even after complete recovery following the presenting episode; 60% of genetic aHUS progresses to end-stage renal disease (ESRD).
Atypical hemolytic-uremic syndrome with I factor anomaly
MedGen UID:
414542
Concept ID:
C2752039
Finding
Hemolytic-uremic syndrome (HUS) is characterized by hemolytic anemia, thrombocytopenia, and renal failure caused by platelet thrombi in the microcirculation of the kidney and other organs. The onset of atypical HUS (aHUS) ranges from the neonatal period to adulthood. Genetic aHUS accounts for an estimated 60% of all aHUS. Individuals with genetic aHUS frequently experience relapse even after complete recovery following the presenting episode; 60% of genetic aHUS progresses to end-stage renal disease (ESRD).
Atypical hemolytic-uremic syndrome with MCP/CD46 anomaly
MedGen UID:
414167
Concept ID:
C2752040
Finding
Hemolytic-uremic syndrome (HUS) is characterized by hemolytic anemia, thrombocytopenia, and renal failure caused by platelet thrombi in the microcirculation of the kidney and other organs. The onset of atypical HUS (aHUS) ranges from the neonatal period to adulthood. Genetic aHUS accounts for an estimated 60% of all aHUS. Individuals with genetic aHUS frequently experience relapse even after complete recovery following the presenting episode; 60% of genetic aHUS progresses to end-stage renal disease (ESRD).

Professional guidelines

PubMed

Leisring J, Brodsky SV, Parikh SV
Arthritis Rheumatol 2024 Feb;76(2):153-165. Epub 2023 Nov 30 doi: 10.1002/art.42681. PMID: 37610060
Subhan M, Scully M
Blood Rev 2022 Sep;55:100945. Epub 2022 Feb 17 doi: 10.1016/j.blre.2022.100945. PMID: 35216839
Raina R, Krishnappa V, Blaha T, Kann T, Hein W, Burke L, Bagga A
Ther Apher Dial 2019 Feb;23(1):4-21. Epub 2018 Oct 29 doi: 10.1111/1744-9987.12763. PMID: 30294946

Recent clinical studies

Etiology

Leisring J, Brodsky SV, Parikh SV
Arthritis Rheumatol 2024 Feb;76(2):153-165. Epub 2023 Nov 30 doi: 10.1002/art.42681. PMID: 37610060
Subhan M, Scully M
Blood Rev 2022 Sep;55:100945. Epub 2022 Feb 17 doi: 10.1016/j.blre.2022.100945. PMID: 35216839
Gupta M, Feinberg BB, Burwick RM
Pregnancy Hypertens 2018 Apr;12:29-34. Epub 2018 Feb 16 doi: 10.1016/j.preghy.2018.02.007. PMID: 29674195
Brocklebank V, Wood KM, Kavanagh D
Clin J Am Soc Nephrol 2018 Feb 7;13(2):300-317. Epub 2017 Oct 17 doi: 10.2215/CJN.00620117. PMID: 29042465Free PMC Article
Carmi O, Berla M, Shoenfeld Y, Levy Y
Expert Rev Hematol 2017 Apr;10(4):365-374. Epub 2017 Mar 13 doi: 10.1080/17474086.2017.1300522. PMID: 28277850

Diagnosis

Genest DS, Patriquin CJ, Licht C, John R, Reich HN
Am J Kidney Dis 2023 May;81(5):591-605. Epub 2022 Dec 10 doi: 10.1053/j.ajkd.2022.10.014. PMID: 36509342
Boyer O, Niaudet P
Pediatr Clin North Am 2022 Dec;69(6):1181-1197. Epub 2022 Oct 29 doi: 10.1016/j.pcl.2022.07.006. PMID: 36880929
Palma LMP, Vaisbich-Guimarães MH, Sridharan M, Tran CL, Sethi S
Pediatr Nephrol 2022 Sep;37(9):1967-1980. Epub 2022 Jan 18 doi: 10.1007/s00467-021-05370-8. PMID: 35041041Free PMC Article
Brocklebank V, Wood KM, Kavanagh D
Clin J Am Soc Nephrol 2018 Feb 7;13(2):300-317. Epub 2017 Oct 17 doi: 10.2215/CJN.00620117. PMID: 29042465Free PMC Article
George JN, Nester CM
N Engl J Med 2014 Aug 14;371(7):654-66. doi: 10.1056/NEJMra1312353. PMID: 25119611

Therapy

Subhan M, Scully M
Blood Rev 2022 Sep;55:100945. Epub 2022 Feb 17 doi: 10.1016/j.blre.2022.100945. PMID: 35216839
Thomas MR, Scully M
Blood 2021 Mar 11;137(10):1310-1317. doi: 10.1182/blood.2019003810. PMID: 33512445Free PMC Article
Neave L, Scully M
Transfus Med Rev 2018 Oct;32(4):230-236. Epub 2018 Aug 18 doi: 10.1016/j.tmrv.2018.08.002. PMID: 30177429
Brocklebank V, Wood KM, Kavanagh D
Clin J Am Soc Nephrol 2018 Feb 7;13(2):300-317. Epub 2017 Oct 17 doi: 10.2215/CJN.00620117. PMID: 29042465Free PMC Article
Joly BS, Coppo P, Veyradier A
Blood 2017 May 25;129(21):2836-2846. Epub 2017 Apr 17 doi: 10.1182/blood-2016-10-709857. PMID: 28416507

Prognosis

Boyer O, Niaudet P
Pediatr Clin North Am 2022 Dec;69(6):1181-1197. Epub 2022 Oct 29 doi: 10.1016/j.pcl.2022.07.006. PMID: 36880929
Hanna RM, Henriksen K, Kalantar-Zadeh K, Ferrey A, Burwick R, Jhaveri KD
Adv Chronic Kidney Dis 2022 Mar;29(2):149-160.e1. doi: 10.1053/j.ackd.2021.11.006. PMID: 35817522
Joly BS, Coppo P, Veyradier A
Expert Rev Hematol 2019 Jun;12(6):383-395. Epub 2019 May 20 doi: 10.1080/17474086.2019.1611423. PMID: 31107120
Brocklebank V, Wood KM, Kavanagh D
Clin J Am Soc Nephrol 2018 Feb 7;13(2):300-317. Epub 2017 Oct 17 doi: 10.2215/CJN.00620117. PMID: 29042465Free PMC Article
Carmi O, Berla M, Shoenfeld Y, Levy Y
Expert Rev Hematol 2017 Apr;10(4):365-374. Epub 2017 Mar 13 doi: 10.1080/17474086.2017.1300522. PMID: 28277850

Clinical prediction guides

Genest DS, Patriquin CJ, Licht C, John R, Reich HN
Am J Kidney Dis 2023 May;81(5):591-605. Epub 2022 Dec 10 doi: 10.1053/j.ajkd.2022.10.014. PMID: 36509342
Tseng MH, Lin SH, Tsai JD, Wu MS, Tsai IJ, Chen YC, Chang MC, Chou WC, Chiou YH, Huang CC
J Formos Med Assoc 2023 May;122(5):366-375. Epub 2022 Oct 30 doi: 10.1016/j.jfma.2022.10.006. PMID: 36323601
Manrique-Caballero CL, Peerapornratana S, Formeck C, Del Rio-Pertuz G, Gomez Danies H, Kellum JA
Crit Care Clin 2020 Apr;36(2):333-356. Epub 2020 Jan 31 doi: 10.1016/j.ccc.2019.11.004. PMID: 32172817
Yoshida Y, Kato H, Ikeda Y, Nangaku M
J Atheroscler Thromb 2019 Feb 1;26(2):99-110. Epub 2018 Nov 2 doi: 10.5551/jat.RV17026. PMID: 30393246Free PMC Article
Gupta M, Feinberg BB, Burwick RM
Pregnancy Hypertens 2018 Apr;12:29-34. Epub 2018 Feb 16 doi: 10.1016/j.preghy.2018.02.007. PMID: 29674195

Recent systematic reviews

Aziz H, Brown ZJ, Baghdadi A, Kamel IR, Pawlik TM
J Gastrointest Surg 2022 Sep;26(9):1998-2007. Epub 2022 Jun 15 doi: 10.1007/s11605-022-05382-1. PMID: 35705835
Lam R, Tarangelo N, Wang R, Horibe M, Grimshaw AA, Jain D, Haffar S, Bazerbachi F, Kunz PL, Li DK
Oncologist 2022 Sep 2;27(9):751-759. doi: 10.1093/oncolo/oyac093. PMID: 35589098Free PMC Article
de Holanda MI, Pôrto LC, Wagner T, Christiani LF, Palma LMP
Clin Rheumatol 2017 Dec;36(12):2859-2867. Epub 2017 Sep 13 doi: 10.1007/s10067-017-3823-2. PMID: 28905254
Morton JM, George JN
J Oncol Pract 2016 Jun;12(6):523-30. doi: 10.1200/JOP.2016.012096. PMID: 27288467
Francis KK, Kalyanam N, Terrell DR, Vesely SK, George JN
Oncologist 2007 Jan;12(1):11-9. doi: 10.1634/theoncologist.12-1-11. PMID: 17227897

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