Mikroangiopaatiad

Mikroangiopaatiad, or microangiopathic conditions, refer to a group of medical disorders characterized by the damage to small blood vessels, known as microvasculature. These conditions primarily affect the endothelial cells lining these vessels, leading to structural and functional impairments. Microangiopathic hemolytic anemia (MAHA) is a hallmark feature, where red blood cells are fragmented or destroyed due to mechanical injury from abnormal blood flow or vessel damage. This often results in anemia, kidney dysfunction, and other systemic complications.

Several microangiopathic syndromes are recognized, including thrombotic thrombocytopenic purpura (TTP), hemolytic-uremic syndrome (HUS), diabetic microangiopathy, and preeclampsia. TTP is an acquired disorder marked by severe thrombocytopenia, microangiopathic hemolytic anemia, fever, and neurological symptoms, often triggered by deficiencies in ADAMTS13, an enzyme that cleaves von Willebrand factor. HUS, commonly linked to bacterial infections (e.g., *Escherichia coli* O157:H7), causes similar hemolysis but often involves kidney failure due to vascular damage.

Diabetic microangiopathy develops over time in patients with diabetes mellitus, leading to retinopathy, nephropathy, and peripheral neuropathy through chronic high glucose-induced endothelial dysfunction and oxidative stress. Preeclampsia, a pregnancy-related disorder, involves widespread endothelial injury, leading to hypertension, proteinuria, and organ dysfunction, sometimes progressing to eclampsia.

Diagnosis relies on laboratory findings such as elevated lactate dehydrogenase (LDH), fragmented red blood cells on peripheral blood smear, and low haptoglobin levels. Imaging and renal function tests may also be used to assess organ involvement. Treatment varies by condition; for example, plasma exchange is standard for TTP, while supportive care and blood pressure management are critical in preeclampsia.

Understanding microangiopaatiad is essential for early intervention, as timely diagnosis can prevent severe complications, including organ failure or long-term disability. Research continues to explore therapeutic targets, such as endothelial repair mechanisms and novel anticoagulants, to improve outcomes.