Thrombotic Microangiopathies (TMA): Diagnostic Approaches and Biomarkers

Thrombotic Microangiopathies (TMA) are a group of disorders characterized by microvascular thrombosis, leading to organ damage.

Introduction

TMA encompasses conditions such as Hemolytic Uremic Syndrome (HUS), Thrombotic Thrombocytopenic Purpura (TTP), and atypical HUS. Early diagnosis is crucial to prevent complications.

Pathophysiology

TMA results from endothelial damage, platelet aggregation, and microvascular occlusion, often leading to hemolysis and organ dysfunction.

Diagnostic Approaches

• Clinical Presentation: Symptoms include thrombocytopenia, microangiopathic hemolytic anemia, and organ dysfunction.
• Laboratory Tests: Includes LDH levels, haptoglobin, and peripheral smear analysis.
• Biomarkers: ADAMTS13 activity assay for TTP diagnosis, complement regulatory proteins for aHUS.
• Imaging: Renal biopsy and MRI for organ-specific assessment.

Biomarkers for TMA

Key biomarkers include:

• ADAMTS13 activity: Differentiates TTP from other TMAs.
• Complement Factors: Identifies atypical HUS.
• Endothelial Injury Markers: Evaluates severity.

Conclusion

Early identification using biomarkers and advanced diagnostics is crucial in managing TMA effectively.