Interesting cases of microangiopathic hemolytic anemia

Microangiopathic hemolytic anemia (MAHA) is a type of hemolytic anemia where there is fragmentation and hemolysis due to damage of erythrocytes in the small blood vessels. The initial evaluation is focused on confirming MAHA and thrombocytopenia and excluding systemic disorders that manifest these findings/mimic thrombotic thrombocytopenic purpura. All patients with a suspected primary thrombotic microangiopathy should have a thorough laboratory workup. ADAMTS13 activity is measured before starting therapeutic plasma exchange (TPE). The immediate management decision is whether to perform TPE or to start anti-complement therapy. Management depends on the specific syndrome.