Thrombotic microangiopathy

• Syndrome of microangiopathic hemolytic anemia, thrombocytopenia, and microvascular thrombosis leading to organ dysfunction

Disease	Clinical Clues
Primary
Thrombotic thrombocytopenia purpura	PT/INR and PTT are normal
Hemolytic-uremic syndrome	PT/INR and PTT are normal, severe AKI
Atypical hemolytic-uremic syndrome	PT/INR and PTT are normal, severe AKI
HELLP syndrome	pregnancy
Secondary
Autoimmune disease, including systemic lupus erythematosus or antiphospholid antibody syndrome
Drug-induced thrombotic microangiopathy	including quinine, ticlopidine, and chemotherapy (mitomycin, gemcitabine, cyclosporine, and tacrolimus, though it may also be caused by the underlying condition
Sepsis
Secondary hemolytic-uremic syndrome	most commonly from Streptococcus pneumoniae or influenza
DIC	PT/INR and PTT are prolonged
Malignancy
HIV