Disease
Pathophysiology
Differentiating Features
Other Thrombotic Microangiopathies
Other Thrombotic Microangiopathies
Other Thrombotic Microangiopathies
DIC
Inflammatory mediated consumptive coagulopathy
- History of infection, malignancy or predisposing factors
- Low fibrinogen
- Schistocytes may be absent
HELLP
Inflammatory mediated consumptive coagulopathy
- Hypertension and proteinuria always present
- Seizures prominent
- LFTs usually elevated
- Schistocytes may be absent
Other
Other
Other
ITP
Immune mediated platelet destruction
- Clinically well
HIT
Immune mediated platelet destruction
- History of heparin exposure
- No evidence of haemolytic anaemia
- Large vessel thrombosis may be present
- Anti-PF4 antibodies may be identified
Heart Valve Haemolysis
Mechanical fragmentation of red blood cells with consumption of platelets
- History of mechanical heart valve
- Heart valve defect on echocardiography
Evan's Syndrome
Immune thrombocytopenia with Coombs positive autoimmune haemolysis
- Schistocytes absent
- Positive Coombs test
Endocarditis
Likely combination of mechanical fragmentation and consumptive coagulopathy
- Vegetations on echocardiography
- Positive blood cultures
Catastrophic anti-phospholipid syndrome
Arterial and venous thrombi with secondary endothelial damage
- Prolonged aPTT
- Positive cardiolipin antibody