Approach to Thrombotic Microangiopathy (TMA) - Differential Diagnosis and Management Algorithm Suspected TMA: Unexplained thrombocytopenia + MAHA ±AKI Initial labs: CBC, BMP, Reticulocytes, smear, Haptoglobin, LDH, Urine hemoglobin/hemosiderin, Hepatic function panel, Direct antiglobulin test, PT/aPTT MAHA likely: • Smear: schistocytes > 1% • ↑ Reticulocyte index • ↑ LDH • ↑ Total/indirect bilirubin • ↓ Haptoglobin • ↑ Urine hemoglobin/ hemosiderin • PT/aPTT normal • DAT negative Matthew Ho, MD PhD @MatthewHoMD #Thrombotic #Microangiopathy #TMA #Differential #Diagnosis #Management #Algorithm #hematology
