Bandaru Sai Samyuktha, Anaji Shiva Charan, Stowe Ifeoluwa T
Internal Medicine, Baton Rouge General Medical Center, Baton Rouge, USA.
Cureus. 2022 Apr 18;14(4):e24237. doi: 10.7759/cureus.24237. eCollection 2022 Apr.
Hypertension causing thrombotic microangiopathy (TMA) is one of the several etiologies of TMA, which causes endothelial damage and thrombosis of microvasculature, leading to hemolytic anemia, thrombocytopenia, and ischemic organ damage. Renal microvasculature involvement leading to renal dysfunction is most frequently seen in TMA but the degree of dysfunction varies with etiology. If left untreated, TMA carries a risk of high mortality, so it is extremely important for early identification of the cause of TMA. Plasma exchange is a commonly used treatment modality for TMA; however, it is not always necessary. Hypertension-induced TMA can be safely treated with antihypertensives, without the need for invasive plasma exchange. We report a 37-year-old African American hypertensive lady presenting with hypertensive emergency and TMA with rapidly progressing renal dysfunction. The patient had improvement in her platelet count after her blood pressure was reduced in a controlled manner.
高血压引起的血栓性微血管病（TMA）是TMA的几种病因之一，它会导致内皮损伤和微血管血栓形成，进而引发溶血性贫血、血小板减少和缺血性器官损伤。导致肾功能障碍的肾微血管受累在TMA中最为常见，但功能障碍的程度因病因而异。如果不进行治疗，TMA有很高的死亡风险，因此早期识别TMA的病因极为重要。血浆置换是TMA常用的治疗方式；然而，并非总是必要的。高血压诱导的TMA可以通过抗高血压药物安全治疗，无需进行侵入性血浆置换。我们报告了一位37岁的非裔美国高血压女性，她因高血压急症和TMA就诊，伴有快速进展的肾功能障碍。在血压得到控制后，患者的血小板计数有所改善。
