title: [Thrombotic microangiopathy : Relevant new aspects for intensive care physicians].
abstract: Thrombotic microangiopathy (TMA) is a clinical syndrome that is characterized by hemolysis, thrombocytopenia, and acute kidney injury, known as atypical hemolytic syndrome (aHUS), thrombotic thrombocytopenic purpura (TTP), and shigatoxin-associated HUS (STEC-HUS) among others. Several diseases, like malignoma, infections, malignant hypertension, or autoimmune disease can result in secondary TMAs. aHUS is caused by a hyperactivated complement system. Identification of the underlying causes of the TMA is the most important issue and directly associated with treatment success. In case of secondary TMAs, treatment of the actual disease is the most important step, while in case of complement-mediated HUS treatment of choice is plasma exchange or anticomplement agents. For the treatment of TTP, rapid initiation of plasma exchange or plasma infusion is the treatment of choice. Patients with STEC-HUS should solely receive supportive treatment.
authors.affiliation: Klinische Abteilung für Nephrologie und Dialyse, Universitätsklinik für Innere Medizin III, Währinger Gürtel 18-20, 1090, Wien, Österreich. martina.gaggl@meduniwien.ac.at.
authors.forename: M
authors.initials: M
authors.lastname: Gaggl
authors.affiliation: Klinische Abteilung für Nephrologie und Dialyse, Universitätsklinik für Innere Medizin III, Währinger Gürtel 18-20, 1090, Wien, Österreich.
authors.forename: C
authors.initials: C
authors.lastname: Aigner
authors.affiliation: Klinische Abteilung für Nephrologie und Dialyse, Universitätsklinik für Innere Medizin III, Währinger Gürtel 18-20, 1090, Wien, Österreich.
authors.forename: G
authors.initials: G
authors.lastname: Sunder-Plassmann
authors.affiliation: Klinische Abteilung für Nephrologie und Dialyse, Universitätsklinik für Innere Medizin III, Währinger Gürtel 18-20, 1090, Wien, Österreich.
authors.forename: A
authors.initials: A
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D001706:Biopsy; D003167:Complement Activation / Q000502:physiology; D003937:Diagnosis, Differential; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D007362:Intensive Care Units; D007668:Kidney / Q000473:pathology; D010956:Plasmapheresis; D011644:Puerperal Disorders / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D011697:Purpura, Thrombotic Thrombocytopenic / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D057049:Thrombotic Microangiopathies / Q000097:blood / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy
keywords: Complement proteins; Hemolysis; Hemolytic–uremic syndrome; Thrombocytopenia; Thrombotic thrombocytopenic purpura