Epidemiology

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Etiology

Immune-Mediated

• Adalimumab (Humira) (see Adalimumab, [[Adalimumab]])
  • Epidemiology: case reports defining an association with thrombotic microangiopathy
• Ciprofloxacin (Cipro) (see Ciprofloxacin, [[Ciprofloxacin]])
  • Epidemiology: case reports defining an association with thrombotic microangiopathy
• Famciclovir (Famvir) (see Famciclovir, [[Famciclovir]])
  • Epidemiology: case reports
• Gemcitabine (Gemzar) (see Gemcitabine, [[Gemcitabine]])
  • Epidemiology: case report of immune-mediated thrombotic microangiopathy (most cases have a toxicity mechanism)
• Mefloquine (see Mefloquine, [[Mefloquine]])
  • Epidemiology: case reports defining an association with thrombotic microangiopathy
• Metronidazole (Flagyl) (see Metronidazole, [[Metronidazole]])
  • Epidemiology: case reports defining an association with thrombotic microangiopathy
• Muromonab-CD3 (Orthoclone OKT3) (see Muromonab-CD3, [[Muromonab-CD3]])
  • Epidemiology: case reports defining an association with thrombotic microangiopathy
• Oxaliplatin (Eloxatin, Oxaliplatin Medac) (see Oxaliplatin, [[Oxaliplatin]])
  • Epidemiology: case reports defining an association with thrombotic microangiopathy
• Penicillin (see Penicillin, [[Penicillin]])
  • Epidemiology: case reports defining an association with thrombotic microangiopathy
• Quetiapine (Seroquel) (see Quetiapine, [[Quetiapine]])
  • Epidemiology: case reports defining an association with thrombotic microangiopathy
    • May recur with repeated exposures
• Quinine (see Quinine, [[Quinine]])
  • Epidemiology: strong evidence for association with thrombotic microangiopathy
• Sulfamethoxazole-Trimethoprim (Bactrim, Septra) (see Sulfamethoxazole-Trimethoprim, [[Sulfamethoxazole-Trimethoprim]])
  • Epidemiology: strong evidence for association with thrombotic microangiopathy

Toxin-Mediated

• Bone Marrow Transplant (BMT)/Stem Cell Transplant (SCT) (see Hematopoietic Stem Cell Transplant, [[Hematopoietic Stem Cell Transplant]])
  • Epidemiology: occurs in 1-20% of cases
    • Occurs with either autologous or allogenenic transplant
  • Physiology: patients typically have received multiple therapies which may be contributory (radiation therapy, cytotoxic chemotherapy, and/or immunosuppressive agents)
• Calcineurin Inhibitors (see Calcineurin Inhibitors, [[Calcineurin Inhibitors]])
  • Agents
    • Cyclosporine A (CSA) (see Cyclosporine A, [[Cyclosporine A]])
    • Tacrolimus (FK-506, Fujimycin, Prograf, Advagraf, Protopic, Hecoria, Astagraf XL) (see Tacrolimus, [[Tacrolimus]])
  • Physiology: dose-dependent endothelial dysfunction and platelet aggregation (possibly mediated by inhibition of prostacyclins)
  • Clinical: organ involvement is usually restricted to the kidneys with acute kidney injury (AKI) (see Acute Kidney Injury, [[Acute Kidney Injury]])
• Cocaine (see Cocaine, [[Cocaine]])
  • Epidemiology: case reports defining an association with thrombotic microangiopathy
• Ecstasy (see Ecstasy, [[Ecstasy]])
  • Epidemiology: case reports defining an association with thrombotic microangiopathy
• Gemcitabine (Gemzar) (see Gemcitabine, [[Gemcitabine]])
  • Epidemiology: strong evidence for association with thrombotic microangiopathy
  • Physiology: dose-dependent toxicity
• Mitomycin (Mitomycin-C) (see Mitomycin, [[Mitomycin]])
  • Epidemiology: strong evidence for association with thrombotic microangiopathy
  • Physiology: dose-dependent toxicity
• Oxymorphone (see Oxymorphone, [[Oxymorphone]]): when long-acting Opana ER is used intravenously as a recreational drug
• Pentostatin (Nipent, Deoxycoformycin) (see Pentostatin, [[Pentostatin]])
  • Epidemiology: case reports defining an association with thrombotic microangiopathy
• Vascular Endothelial Growth Factor (VEGF) Inhibitors
  • Agents
    • Bevacizumab (Avastin) (see Bevacizumab, [[Bevacizumab]]): anti-VEGF monoclonal antibody
    • Sunitinib (Sutent) (see Sunitinib, [[Sunitinib]]): small molecule tyrosine kinase inhibitor, targeting multiple receptors (c-kit, VEGFR1-3, PDGFR-alpha, PDGFR-beta, FLT3, CSF-1R, and REarranged during Transfection; RET)
• Vincristine (see Vincristine, [[Vincristine]])
  • Epidemiology: case reports defining an association with thrombotic microangiopathy

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Physiology

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Diagnosis

ADAMTS 13 Activity (see ADAMTS 13 Activity, [[ADAMTS 13 Activity]])

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Clinical Manifestations

Other Manifestations

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Treatment

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References

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