Microangiopathic Hemolysis and Renal Failure in Malignant Hypertension

Born, B.J.H. van den; Koopmans, Richard P.; Honnebier, U.; Montfrans, Gert A. van

doi:10.1097/00004872-200406002-00270

Cited by 9 publications

(16 citation statements)

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“…However, black individuals had higher systolic blood pressure levels and more hypertensive organ damage than white individuals with malignant hypertension. We previously reported on the predominance of microangiopathic haemolysis in black patients as evidence of more severe vascular damage and its association with renal dysfunction [11]. There was no difference in the severity of retinopathy between black and white patients, which is in agreement with previous reports indicating that the clinical characteristics and survival of patients with grades III and IV hypertensive retinopathy are not different [12].…”

Section: Discussionsupporting

confidence: 91%

Ethnic disparities in the incidence, presentation and complications of malignant hypertension

Born¹,

Koopmans

Groeneveld

et al. 2006

Journal of Hypertension

107

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Section: Discussionsupporting

confidence: 91%

Ethnic disparities in the incidence, presentation and complications of malignant hypertension

Born¹,

Koopmans

Groeneveld

et al. 2006

Journal of Hypertension

107

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“…Malignant hypertension can lead to decreased RBC survival with the finding of schistocytes on blood smear. 244 Theoretically, this could result in free heme, recently shown to induce complement activation on endothelial cells and may serve as a second hit in the presence of complement mutations. 245 In keeping with this, in a patient with malignant hypertension and subsequent TMA, a CFH variant was found.…”

Section: Thrombotic Microangiopathy Associated With Malignant Hypertementioning

confidence: 99%

Spectrum of Complement-Mediated Thrombotic Microangiopathies: Pathogenetic Insights Identifying Novel Treatment Approaches

Riedl

Fakhouri

Quintrec

et al. 2014

Semin Thromb Hemost

125

116

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Thrombotic microangiopathy (TMA) is a rare but severe disorder characterized by endothelial cell activation and thrombus formation. It manifests with the triad of hemolytic anemia, thrombocytopenia, and organ failure. Prompt diagnosis and treatment initiation are crucial for long-term outcome. TMA often manifests subsequent to infectious events, of which (enterohemorrhagic) Escherichia coli is the most frequently reported. TMA also occurs on the background of genetic/autoimmune defects in the complement system (atypical hemolytic uremic syndrome [aHUS]) and underlying conditions, such as pregnancy, transplantation, drugs, other glomerulopathies, vasculitides, or metabolic defects. Complement activation or defects in its regulation have now been described in an increasing number of acquired diseases with TMA. Coinciding with this expanding spectrum of complement-mediated diseases, the question arises which patients might benefit from a complement-targeted therapy. Success of therapy depends on the individual contribution of complement activation in disease pathogenesis. The advent of eculizumab, a monoclonal antibody that blocks terminal complement activation, has markedly improved outcome and quality of life in patients with aHUS. This review discusses the contribution of complement and highlights its complex interaction with inflammation, coagulation, and the endothelium. Treatment experiences focusing on eculizumab therapy are discussed in detail across the emerging spectrum of complement-mediated thrombotic microangiopathies.

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“…van den Born et al defined microangiopathic hemolysis (MAHA) related to malignant hypertension as follows: (1) a low platelet count (<150×10 9 /L) together with either an elevated lactic dehydrogenase (LDH) level (>220 IU/L) or detection of schistocytes or both and (2) normalization of the platelet count, the LDH level and/or the presence of schistocytes after achieving adequate blood pressure control (7). Accordingly, we also investigated the levels of platelets, LDH and haptoglobin (Hpt).…”

Section: Laboratory Datamentioning

confidence: 99%

Clinical and Pathological Evaluation of Hypertensive Emergency-Related Nephropathy

et al. 2013

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An onion skin pattern of the arterioles is the most frequent histological finding in patients with hypertensive emergency-related nephropathy. Long-standing hypertension might contribute to this arteriolar change, since left ventricular hypertrophy was also seen in these patients. With strict control of hypertension using antihypertensive medications, the prognosis of patients with hypertensive emergency-related nephropathy can be improved.

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Microangiopathic Hemolysis and Renal Failure in Malignant Hypertension

Cited by 9 publications

References 0 publications

Ethnic disparities in the incidence, presentation and complications of malignant hypertension

Ethnic disparities in the incidence, presentation and complications of malignant hypertension

Spectrum of Complement-Mediated Thrombotic Microangiopathies: Pathogenetic Insights Identifying Novel Treatment Approaches

Clinical and Pathological Evaluation of Hypertensive Emergency-Related Nephropathy

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