Quinine is the most common cause of Drug induced thrombotic microangiopathy (DITMA), being the offending drug in 33% of cases. We present a case of DITMA after only a single dose of quinine with no previous history of quinine exposure treated successfully with plasma exchange (PEX), oral corticosteroid followed by mycophenolatemofetil (MMF). The diagnosis was made by the close temporal relation...

BACKGROUND Thrombotic microangiopathy (TMA) is a serious, sometimes life-threatening disorder marked by the presence of endothelial injury and microvascular thrombi. Drug-induced thrombotic microangiopathy (DI-TMA) is one specific TMA syndrome that occurs following drug exposure via drug-dependent antibodies or direct tissue toxicity. Common examples include calcineurin inhibitors Tacrolimus an...

Thrombotic microangiopathy (TMA) is a severe complication of kidney transplantation that often causes graft failure. TMA may occur de novo, often triggered by immunosuppressive drugs and acute antibody-mediated rejection, or recur in patients with previous history of hemolytic uremic syndrome (HUS). Recurrent TMA is very rare in patients who had developed end-stage renal failure following HUS c...

The term “thrombotic microangiopathy” (TMA) encompasses non-inflammatory small vessel vasculopathies that are caused by severe endothelial and medial smooth muscle cell injury/necrosis. TMAs can be promoted by a variety of “toxic” stimuli ranging from malignant range hypertension, E. coli infections with bloody diarrhea, radiation, systemic diseases such as scleroderma to iatrogenic events such...

The endothelium lining the vascular lumen is continuously exposed to complement from the circulation. When erroneously activated on host cells, complement may generate a deleterious effect on the vascular wall leading to endothelial injury, exposure of the subendothelial matrix and platelet activation. In this review the contribution of complement activation to formation and maintenance of the ...

Haemolytic uraemic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) are closely related disorders characterised by non-immune microangiopathic haemolytic anaemia and thrombocytopenia. Thrombotic microangiopathy is the underlying pathologic lesion in both syndromes. Under physiological conditions, platelets bind to endothelium via von Willebrand Factor (vWF) and are released back int...

A 4-year-old boy presented with proteinuria and developed progressive renal failure over 6 years. In the patient's family, five individuals were affected with atypical haemolytic uraemic syndrome (aHUS) but not the patient. Renal biopsies (n = 3) showed glomerular basement membrane thickening with double contours, endothelial swelling and deposits of C3 and C1q. Electron microscopy revealed mes...

Implication for health policy/practice/research/medical education: Thrombotic microangiopathy (TMA) occurs in IgA nephropathy, but is uncommon in the setting of IgA nephropathy. However, the reports of overlapping morphologic lesions of TMA and IgAN are poorly understood and debatable and needs more attention in larger series of IgAN. Copyright © 2013, Iranian Red Crescent Medical Journal; Publ...

Objectives and study A 4year-old boy was admitted to our hospital because of progressive proximal muscular weakness of 4 weeks duration, heliotrope rash, erythematous skin lesions in the trunk and limbs and febrile fever. The muscle enzymes were elevated: creatine kinase 7,056 IU/L (0– 170), aldolase 40.3 U/L (0–8), aspartate transaminase 601 U/L (10–37), alanine transaminase 289 U/L (10–37). T...