Microangiopathic hemolytic anemias

• • Hemolysis is from narrowing or obstructions in microvasculature

  • Will see things that look like bite cells as well as small fragments of RBCs

  • DIC

    • The presence of microthrombi in capillaries

    • Always secondary; may be seen with metastatic malignancies, sepsis, severe burns, etc

  • HUS

    • F, ARF, and thrombocytopenia

    • There is deposition of microthrombi in renal arterioles and glomerular capillaries due to endothelial damage

    • Can come from infection with enterics or S. pneumoniae in kids or with pregnancy, autoimmunity, or immune suppression in adults; it carries a better prognosis in kids

  • Thrombotic thrombocytopenic purpura (TTP)

    • Like HUS, but there’s also CNS C/S

    • Most common in young adults, and is seen more often in women

    • Used to be 90% fatal; early recognition and treatment with plasmapheresis has dropped the mortality

  • Malignant HTN (narrowing of arterioles)

  • Renal cortical necrosis

  • Necrotizing arteritis (SLE)

  • Kasabach-Merrit syndrome (from formation of microthrombi in a congenital giant cavernous hemangioma)

• Cardiac traumatic hemolytic anemia (AKA macroangiopathic hemolysis)

  • Diseased or mechanical valves damage RBCs

  • The biggest problem was the ole ball in cage heart valve

Category: Medical Subject Notes , Pathology Notes