Thrombotic Microangiopathy Care Pathway: A Consensus Statement for the Mayo Clinic Complement Alternative Pathway-Thrombotic Microangiopathy (CAP-TMA) Disease-Oriented Group

被引:56
作者
Go, Ronald S. [1 ]
Winters, Jeffrey L. [2 ]
Leung, Nelson [3 ]
Murray, David L. [2 ]
Willrich, Maria A. [2 ]
Abraham, Roshini S. [2 ]
Amer, Hatem [3 ]
Hogan, William J. [1 ]
Marshall, Ariela L. [1 ]
Sethi, Sanjeev [2 ]
Tran, Cheryl L. [4 ]
Chen, Dong [2 ]
Pruthi, Rajiv K. [1 ]
Ashrani, Aneel A. [1 ]
Fervenza, Fernando C. [3 ]
Cramer, Carl H., II [4 ]
Rodriguez, Vilmarie [5 ]
Wolanskyj, Alexandra P. [1 ]
Thome, Stephan D. [6 ]
Hook, C. Christopher [1 ]
机构
[1] Mayo Clin, Div Hematol, 200 First St SW, Rochester, MN 55905 USA
[2] Mayo Clin, Dept Lab Med & Pathol, Rochester, MN USA
[3] Mayo Clin, Div Nephrol & Hypertens, Rochester, MN USA
[4] Mayo Clin, Div Pediat Nephrol, Rochester, MN USA
[5] Mayo Clin, Div Pediat Hematol Oncol, Rochester, MN USA
[6] Mayo Clin, Div Community Oncol, Rochester, MN USA
关键词
HEMOLYTIC-UREMIC SYNDROME; ANTIBODY-MEDIATED REJECTION; THERAPEUTIC PLASMA-EXCHANGE; RENAL-TRANSPLANT RECIPIENTS; UPSHAW-SCHULMAN SYNDROME; FRESH-FROZEN PLASMA; THROMBOCYTOPENIC PURPURA; ESCHERICHIA-COLI; ADAMTS-13; ACTIVITY; OKLAHOMA REGISTRY;
D O I
10.1016/j.mayocp.2016.05.015
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Thrombotic microangiopathies (TMAs) comprise a heterogeneous set of conditions linked by a common histopathologic finding of endothelial damage resulting in microvascular thromboses and potentially serious complications. The typical clinical presentation is microangiopathic hemolytic anemia accompanied by thrombocytopenia with varying degrees of organ ischemia. The differential diagnoses are generally broad, while the workup is frequently complex and can be confusing. This statement represents the joint recommendations fromamultidisciplinary team of Mayo Clinic physicians specializing in the management of TMA. It comprises a series of evidence- and consensus-based clinical pathways developed to allow a uniform approach to the spectrum of care including when to suspect TMA, what differential diagnoses to consider, which diagnostic tests to order, and how to provide initial empiric therapy, as well as some guidance on subsequent management. (C) 2016 Mayo Foundation for Medical Education and Research
引用
收藏
页码:1189 / 1211
页数:23
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