Thrombotic microangiopathy syndromes.
Primary TMAa) |
TTP |
Congenital |
Acquired (immune-mediated) |
Complement mediated atypical hemolytic uremic syndrome |
Congenital |
Acquired |
Secondary TMA |
Shiga toxin producing |
Disseminated intravascular coagulation |
Infection associated TMA |
Cancer associated TMA |
Drug induced TMA |
Immune-mediated |
Toxic |
Transplant associated TMA |
Malignant hypertension |
Autoimmune disease (e.g., systemic lupus erythematosus, systemic sclerosis, antiphospholipid syndrome) associated TMA |
Pregnancy associated TMA |
Pre-eclampsia, eclampsia |
HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) |
a)Precipitating factors, such as infections and pregnancy, may trigger an acute episode of primary thrombotic microangiopathy (TMA). Some patients with transplant-associated or pregnancy- associated TMA have a genetic predisposition.