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Microangiopathic Hemolytic Anemia

Schistocyte-Associated Mechanical Erythrocyte Destruction

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Hematoloji department. Book Appointment →

What is Microangiopathic Hemolytic Anemia?

A pattern of intravascular hemolysis caused by mechanical fragmentation of red blood cells in damaged microvasculature

Hallmark feature is schistocytes (fragmented red cells) on peripheral blood smear

Hallmark laboratory triad includes anemia, thrombocytopenia, and elevated lactate dehydrogenase

Underlies thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, HELLP, and other thrombotic microangiopathies

May also occur with malignant hypertension, prosthetic valves, and disseminated cancer

Symptoms

Pallor, fatigue, and dyspnea from rapidly developing anemia
Petechiae, purpura, and bleeding from associated thrombocytopenia
Renal dysfunction with elevated creatinine and proteinuria
Neurologic symptoms ranging from headache to confusion, seizures, and stroke
Fever, abdominal pain, and ischemic injury to multiple organs

Risk Factors

Pregnancy, particularly with HELLP syndrome and preeclampsia
Shiga toxin-producing Escherichia coli or other enteric infections
Autoimmune diseases such as systemic lupus erythematosus and antiphospholipid syndrome
Drugs including quinine, calcineurin inhibitors, gemcitabine, and bevacizumab
Disseminated cancer, allogeneic stem cell transplantation, and complement gene mutations

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Sudden anemia and thrombocytopenia with schistocytes on blood smear
  • Acute kidney injury, neurologic deterioration, or pregnancy with hypertension
  • Bloody diarrhea preceding renal failure and anemia in children
  • Patients on cancer chemotherapy or immunosuppressants developing cytopenias
  • Need for emergency hematology consultation and possible plasma exchange

Treatment Methods

01
Urgent recognition and risk stratification with PLASMIC or French TMA scores
02
Plasma exchange for thrombotic thrombocytopenic purpura while awaiting ADAMTS13 results
03
Eculizumab or ravulizumab for atypical hemolytic uremic syndrome
04
Treatment of underlying cause including delivery in HELLP and antibiotics in infection
05
Supportive transfusion of red cells, platelets only when bleeding, and intensive care monitoring

Which Department to Visit?

You can visit our Hematoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Hematoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.