Thrombotic microangiopathy with renal injury: an approach for the general physician

Abstract

Thrombotic microangiopathy with renal dysfunction is a haematological and renal emergency warranting urgent diagnosis and intervention. As the potential underlying causes may be complex, assessment and management can be challenging for treating clinicians, and a timely and collaborative approach between general physicians, haematologists and nephrologists may be extremely helpful in order to optimise clinical outcomes. This paper will aim to build an understanding of different potential presentations of thrombotic microangiopathies and provide a practical framework for diagnosis and management, using a case-based discussion format, for acute and general physicians. Some aspects of subsequent specialist management are also discussed.

Keywords: haemolytic uraemic syndrome; microangiopathic haemolytic anaemia; renal injury; thrombotic microangiopathy; thrombotic thrombocytopenic purpura.