Difference between revisions of "Thrombotic microangiopathy"
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'''Thrombotic microangiopathy''' is a group of disorders affecting small blood vessels. ''Microangiopathic'' is a disease affecting small blood vessels.<ref>URL: [http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/one/000005089.htm http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/one/000005089.htm]. Accessed on: 9 September 2010.</ref> | '''Thrombotic microangiopathy''' is a group of disorders affecting small blood vessels. ''Microangiopathic'' is a disease affecting small blood vessels.<ref>URL: [http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/one/000005089.htm http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/one/000005089.htm]. Accessed on: 9 September 2010.</ref> | ||
==Differential diagnosis== | |||
The grouping includes:<ref>URL: [http://emedicine.medscape.com/article/779218-overview http://emedicine.medscape.com/article/779218-overview]. Accessed on: 8 November 2010.</ref><ref name=pmid15915311>{{cite journal |author=Mayer SA, Aledort LM |title=Thrombotic microangiopathy: differential diagnosis, pathophysiology and therapeutic strategies |journal=Mt. Sinai J. Med. |volume=72 |issue=3 |pages=166–75 |year=2005 |month=May |pmid=15915311 |doi= |url=}}</ref> | The grouping includes:<ref>URL: [http://emedicine.medscape.com/article/779218-overview http://emedicine.medscape.com/article/779218-overview]. Accessed on: 8 November 2010.</ref><ref name=pmid15915311>{{cite journal |author=Mayer SA, Aledort LM |title=Thrombotic microangiopathy: differential diagnosis, pathophysiology and therapeutic strategies |journal=Mt. Sinai J. Med. |volume=72 |issue=3 |pages=166–75 |year=2005 |month=May |pmid=15915311 |doi= |url=}}</ref> | ||
*[[Hemolytic uremic syndrome]]. | *[[Hemolytic uremic syndrome]]. | ||
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*[[DIC]]. | *[[DIC]]. | ||
*[[APLA]] in [[SLE]]. | *[[APLA]] in [[SLE]]. | ||
*Scleroderma renal crisis. | *[[Scleroderma]] renal crisis. | ||
*HIV associated TTP. | *[[HIV]] associated TTP. | ||
*Chemotherapy. | *Chemotherapy. | ||
*Calcineurin inhibitor toxicity. | *Calcineurin inhibitor toxicity. | ||
Notes: | |||
*The above cannot be differentiated on a histomorphologic basis. | |||
==General== | |||
*Underlying pathology: endothelial cell damage. | |||
==Microscopic== | ==Microscopic== | ||
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Notes: | Notes: | ||
*The last two (#2 and #3) are useful for discrimination from endarteritis.<ref name=Ref_FoRP>{{Ref FoRP|204}}</ref> | *The last two (#2 and #3) are useful for discrimination from endarteritis.<ref name=Ref_FoRP>{{Ref FoRP|204}}</ref> | ||
*Early finding: endothelial cell swelling. | |||
Image: | Image: | ||
Revision as of 15:44, 7 November 2011
Thrombotic microangiopathy is a group of disorders affecting small blood vessels. Microangiopathic is a disease affecting small blood vessels.[1]
Differential diagnosis
Others:
- Malignant hypertension.
- DIC.
- APLA in SLE.
- Scleroderma renal crisis.
- HIV associated TTP.
- Chemotherapy.
- Calcineurin inhibitor toxicity.
Notes:
- The above cannot be differentiated on a histomorphologic basis.
General
- Underlying pathology: endothelial cell damage.
Microscopic
Features:[4]
- Microvascular occlusion.[5]
- "Loose" intimal thickening; fluffy appearing intima.
- May be have an onion skin-like appearance.
- Fibrin entrapped RBCs.
Notes:
- The last two (#2 and #3) are useful for discrimination from endarteritis.[4]
- Early finding: endothelial cell swelling.
Image:
See also
References
- ↑ URL: http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/one/000005089.htm. Accessed on: 9 September 2010.
- ↑ URL: http://emedicine.medscape.com/article/779218-overview. Accessed on: 8 November 2010.
- ↑ Mayer SA, Aledort LM (May 2005). "Thrombotic microangiopathy: differential diagnosis, pathophysiology and therapeutic strategies". Mt. Sinai J. Med. 72 (3): 166–75. PMID 15915311.
- ↑ 4.0 4.1 Fogo, Agnes; Bruijn, Jan A.; Cohen, Arthur H.; Colvin, Robert B.;Jennette, J. Charles (2006). Fundamentals of Renal Pathology (1st ed.). Springer. pp. 204. ISBN 978-0387311265.
- ↑ Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; Aster, Jon (2009). Robbins and Cotran pathologic basis of disease (8th ed.). Elsevier Saunders. pp. 670. ISBN 978-1416031215.
- ↑ Ruggenenti, P.; Noris, M.; Remuzzi, G. (Sep 2001). "Thrombotic microangiopathy, hemolytic uremic syndrome, and thrombotic thrombocytopenic purpura.". Kidney Int 60 (3): 831-46. doi:10.1046/j.1523-1755.2001.060003831.x. PMID 11532079.