Thrombotic microangiopathies

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-	*Risk factors	+	*HUS/TTP, antiphospholipid syndrome, malignant HT., systemic sclerosis (renal crisis), HIV, pregnancy (preeclampsia, HELLP: hemolysis, elevated liver enzymes, low platelet count), hematopoietic stem cell transplantation
-	**Pregnancy, pills, quinine, RT p'ts given OKT3 for rejection, calcineurin inhibitors (cyclosporine, tacrolimus), antiplatelets (ticlopidine and clopidogrel), HIV	+	*Pentad: thrombocytopenic purpura, intravascular hemolytic anemia (fragmented RBCs), fever, + AKI (HUS), + neurol. dis. (TTP)
-	*Clinical features	+	*Drugs: mitomycin, gemcitabine, VEGF inh., anti-rejection (calcineurin inhibitors, OKT3), pills, antiplatelets (ticlopidine, clopidogrel, prasugrel), quinine
-	**Thrombocytopenic purpura, hemolytic anemia, fever, renal failure (esp. HUS), neurologic disturbances (esp. TTP)	+	*PT, aPTT: normal
-	*Pathology	+	*Interlobular artery, arterioles, glomerular capillaries: microthrombi, AKI
-	**Endotheliosis with fibrin thrombi	+	*DD: DIC, SLE, cancer
-	*1st classification	+
-	**Thrombotic thrombocytopenic purpura (TTP)	+
-	**[[Hemolytic-uremic syndrome (HUS)]]	+
-	*2nd classification	+
-	**Adult HUS/TTP	+
-	***Familial: ADAMTS13 metalloprotease (that cleaves large multimers of von Willebrand's factor) deficiency	+
-	***Sporadic	+
-	****Some p'ts have antibody to ADAMTS13 or thrombospondin receptor on endothelial cells	+
-	****Some p'ts have plasminogen-activator inhibitor 1 ↑	+
-	**Childhood HUS	+
-	***''Escherichia coli O157:H7'' (occasionally Shigella dysenteriae) causing enterohemorrhagic diarrhea	+
-	*Treatment	+
-	**Daily [[plasmapheresis]]	+
-	**Patients with childhood HUS from infectious diarrhea are ''not given antibiotics'', as antibiotics are thought to accelerate the release of the toxin and the diarrhea is usually self-limited.	+

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在2018年3月27日 (二) 12:35所做的修訂版本

• HUS/TTP, antiphospholipid syndrome, malignant HT., systemic sclerosis (renal crisis), HIV, pregnancy (preeclampsia, HELLP: hemolysis, elevated liver enzymes, low platelet count), hematopoietic stem cell transplantation
• Pentad: thrombocytopenic purpura, intravascular hemolytic anemia (fragmented RBCs), fever, + AKI (HUS), + neurol. dis. (TTP)
• Drugs: mitomycin, gemcitabine, VEGF inh., anti-rejection (calcineurin inhibitors, OKT3), pills, antiplatelets (ticlopidine, clopidogrel, prasugrel), quinine
• PT, aPTT: normal
• Interlobular artery, arterioles, glomerular capillaries: microthrombi, AKI
• DD: DIC, SLE, cancer