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



Cardiac valve prostheses – leaks, para-vavular leaks


Carcinoma - usually disseminated/advanced




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




March haemoglobinuria

Haemoglobin urine, after appropriate exercise.

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