Microangiopathic hemolytic anemia (patient information)

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Associate Editor(s)-in-Chief: Mydah Sajid, MD[1]

Overview

Microangiopathic hemolytic anemia is a type of intra-vascular hemolysis that occurs due to a number of diseases. It is a clinical emergency and requires immediate treatment.

What are the symptoms of Microangiopathic hemolytic anemia?

It presents with wide range of clinical symptoms:

• Anemia
• Jaundice
• Petechia
• Purpura
• Mucosal bleeding
• Oliguria
• Neurological involvement

What causes Microangiopathic hemolytic anemia?

It is a clinical manifestation of a large number of underlying diseases including:

• Aortic stenosis
• Thrombotic thrombocytopenic purpura
• Hemolytic uremic syndrome
• Disseminated intravascular coagulation
• Cancer
• Mechanical heart valve

When to seek urgent medical care?

It is a medical emergency. Any patients presenting with high clinical suspicion should be given immediate treatment.

Diagnosis

The diagnosis of microangiopathic hemolytic anemia is made by carrying out blood tests and visualizing schistocytes on peripheral blood smear. The blood tests show:

• Anemia
• Elevated lactate dehydrogenase
• Raised bilirubin
• Thrombocytopenia
• Deranged liver and renal function tests

Treatment

The treatment of choice is Plasma exchange. Other treatment option include

• Large volume plasma infusion
• Infusion of fresh frozen plasma
• Folate supplementation
• Anti-platelet therapy
• Corticosteroids

Possible complications

Acute renal failure, intracranial hemorrhage and myocardial infarction are the possible complications.