Babar Faizan, Cohen Scott D
Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University, 2150 Pennsylvania Avenue, Washington, DC 20037, USA.
Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University, 2150 Pennsylvania Avenue, Washington, DC 20037, USA.
Rheum Dis Clin North Am. 2018 Nov;44(4):635-649. doi: 10.1016/j.rdc.2018.06.010. Epub 2018 Sep 7.
Thrombotic microangiopathies are heterogeneous disorders characterized by microangiopathic hemolytic anemia with thrombocytopenia and renal injury. There are a variety of causes, including metabolic disorders, infections, medications, complement disorders, pregnancy, malignancy, and autoimmune disorders. This review focuses on renal thrombotic microangiopathy in the setting of rheumatologic diseases. Systemic lupus erythematosus is the most common autoimmune disease associated with thrombotic microangiopathy. Other etiologies include scleroderma renal crisis and antiphospholipid antibody syndrome, which can be primary or secondary to autoimmune diseases including systemic lupus erythematosus. There have also been case reports of thrombotic microangiopathy in the setting of rheumatoid arthritis and dermatomyositis.
血栓性微血管病是一类异质性疾病,其特征为微血管病性溶血性贫血伴血小板减少和肾损伤。病因多种多样,包括代谢紊乱、感染、药物、补体紊乱、妊娠、恶性肿瘤和自身免疫性疾病。本综述聚焦于风湿性疾病背景下的肾血栓性微血管病。系统性红斑狼疮是与血栓性微血管病相关的最常见自身免疫性疾病。其他病因包括硬皮病肾危象和抗磷脂抗体综合征,后者可为原发性,也可为包括系统性红斑狼疮在内的自身免疫性疾病继发。也有关于类风湿关节炎和皮肌炎背景下血栓性微血管病的病例报告。