Advertisement

The Root of This Evil: Microangiopathic Hemolytic Anemia and Renal Failure

Published:September 09, 2014DOI:https://doi.org/10.1016/j.amjmed.2014.08.021
      Diagnosed with hypertension 10 years earlier, a 27-year-old Asian man avoided medical treatment and monitoring until he became severely ill. He presented to the emergency department after 2 weeks of frontal headache and blurry vision and several days of decreased urine output. Although he had been informed of an abnormal creatinine level 2 years earlier, he underwent no work-up. Otherwise, his medical and family histories were unremarkable. He took no prescription, over-the-counter, or alternative medications.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Tsai H.M.
        Untying the knot of thrombotic thrombocytopenic purpura and atypical hemolytic uremic syndrome.
        Am J Med. 2013; 126: 200-209
        • George J.N.
        • Al-Nouri Z.L.
        Diagnostic and therapeutic challenges in the thrombotic thrombocytopenic purpura and hemolytic uremic syndromes.
        Hematology Am Soc Hematol Educ Program. 2012; 2012: 604-609
        • Shibagaki Y.
        • Fujita T.
        Thrombotic microangiopathy in malignant hypertension and hemolytic uremic syndrome (HUS)/thrombotic thrombocytopenic purpura (TTP): can we differentiate one from the other?.
        Hypertens Res. 2005; 28: 89-95
        • Noris M.
        • Mescia F.
        • Remuzzi G.
        STEC-HUS, atypical HUS and TTP are all diseases of complement activation.
        Nat Rev Nephrol. 2012; 8: 622-633
        • Legendre C.M.
        • Licht C.
        • Muus P.
        • et al.
        Terminal complement inhibitor eculizumab in atypical hemolytic–uremic syndrome.
        N Engl J Med. 2013; 368: 2169-2181
        • Rovira J.
        • Cid J.
        • Gutiérrez-García G.
        • et al.
        Fatal immune hemolytic anemia following allogeneic stem cell transplantation: report of 2 cases and review of literature.
        Transfus Med Rev. 2013; 27: 166-170
        • van den Born B.J.
        • Honnebier U.P.
        • Koopmans R.P.
        • van Montfrans G.A.
        Microangiopathic hemolysis and renal failure in malignant hypertension.
        Hypertension. 2005; 45: 246-251
        • Vaughan C.J.
        • Delanty N.
        Hypertensive emergencies.
        Lancet. 2000; 356: 411-417