Hemolysis

Microangiopathic Anemia

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Microangiopathic Anemia, Microangiopathic Hemolytic Anemia, Fragmentation Hemolysis, MAHA

  • See Also
  1. Hemolytic Anemia
  • Mechanism
  1. RBCs damaged by injured vessel endothelium
  2. Results in Schistocyte formation
  • Causes
  1. Prosthetic Heart Valve
  2. Recent Coronary Artery Bypass Surgery or ECMO
  3. Arteriovenous Malformation
  4. Vasculitis
  5. Malignant Hypertension
  6. Eclampsia or HELLP Syndrome
  7. Renal Graft Rejection
  8. Giant Hemangioma
  9. Scleroderma
  10. Thrombotic Thrombocytopenic Purpura (TTP)
  11. Hemolytic Uremic Syndrome (HUS)
  12. Disseminated Intravascular Coagulation (DIC)
  13. March Hemoglobinuria (Marathon runners)
  14. Drug-Induced Thrombotic Microangiopathic Anemia (5% of MAHA causes)
    1. Most commonly due to Quinine, Cyclosporine, Tacrolimus
  • Exam
  1. Blood Pressure
  • Labs
  1. Peripheral Smear
    1. Schistocytes
  2. Liver Function Tests
  3. Renal Function Tests
  4. ProTime (PT)
  5. Partial Thromboplastin Time (aPTT)
  • References
  1. Udden in Goldman (2000) Cecil Medicine. p. 882-4
  2. Phillips (2018) Am Fam Physician 98(6): 354-61 [PubMed]