title: [Diagnostic and therapeutic guidelines of thrombotic microangiopathies of the Spanish Apheresis Group].
abstract: Thrombotic microangiopathies (TMA) are disorders defined by the presence of a microangiopathic hemolytic anemia (with the characteristic hallmark of schistocytes in the peripheral blood smear), thrombocytopenia and organ malfunction of variable intensity. Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome are the most important forms of TMA and, without the adequate treatment, they are associated with high morbimortality. In recent years, significant advances in the knowledge of the pathophysiology of TMA have occurred. Those advances have allowed us to move from a syndromic diagnosis with a similar treatment to all entities to the search of etiologic diagnosis which would lead to a specific treatment, finally leading to a better outcome of the patient. This document pretends to summarize the current status of knowledge of the pathophysiology of TMA and the therapeutic options available, and to offer a diagnostic and therapeutic practical tool to the professionals caring for the patients.
authors.affiliation: Banc de Sang i Teixits, Tarragona, España.
authors.forename: Enric
authors.initials: E
authors.lastname: Contreras
authors.affiliation: Servicio de Hematología y Hemoterapia, Hospital Dr. Peset, Universidad Católica San Vicente Mártir, Valencia, España.
authors.forename: Javier
authors.initials: J
authors.lastname: de la Rubia
authors.affiliation: Servicio de Hematología, Complejo Hospitalario Universitario, Orense, España.
authors.forename: Julio
authors.initials: J
authors.lastname: Del Río-Garma
authors.affiliation: Servicio de Hemoterapia y Hemostasia, Hospital Clínic Universitari, Barcelona, España.
authors.forename: Maribel
authors.initials: M
authors.lastname: Díaz-Ricart
authors.affiliation: Servicio de Hematología y Hemoterapia, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
authors.forename: José María
authors.initials: JM
authors.lastname: García-Gala
authors.affiliation: Servicio de Hemoterapia y Hemostasia, Hospital Clínic Universitari, Barcelona, España. Electronic address: mlozano@clinic.ub.es.
authors.forename: Miguel
authors.initials: M
authors.lastname: Lozano
mesh_terms: D001781:Blood Component Removal; D003131:Combined Modality Therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D010951:Plasma Exchange; D057049:Thrombotic Microangiopathies / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy
chemical_list: D007166:Immunosuppressive Agents
keywords: Aféresis; Apheresis; Hemolytic uremic syndrome; Microangiopatía trombótica; Plasma exchange; Púrpura trombocitopénica trombótica; Recambios plasmáticos; Síndrome urémico hemolítico; Thrombotic microangiopathy; Thrombotic thrombocytopenic purpura