Microangiopathic haemolysis

Key information

Appropriate Tests

Microangiopathic haemolytic anaemia (MAHA) is a non-immune haemolysis with prominent red cell fragmentation observed on peripheral blood film. 

Full blood count, Blood film, Platelet count, Reticulocyte count; Bilirubin, Haptoglobin, Lactate dehydrogenase; Haemoglobin urine, Haemosiderin urine.

Urea, Creatinine, eGFR, LFT.

Coagulation testing, especially PT, APTT, Fibrinogen, D Dimer.

ADAMTS-13 activity assay may be indicated if Thrombotic thrombocytopenic purpura (TTP) is considered and should be collected prior to therapy if possible.

See also Disseminated intravascular coagulation, Haemolysis

Causes

 

Cardiac valve prostheses – leaks, para-vavular leaks

 

Carcinoma - usually disseminated/advanced

 

DIC

 

Malignant hypertension

 

Pregnancy-induced hypertension

See Hypertension

Haemolytic uraemic syndrome

 

Thrombotic thrombocytopenic purpura (TTP)

See ADAMTS-13 activity assay

Renal graft rejection

 

Drugs, especially

  • Cyclosporine
  • Mitomycin C

 

Haemangiomas

 

March haemoglobinuria

Haemoglobin urine, after appropriate exercise.