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Klinik und Differenzialdiagnose der thrombotischen Mikroangiopathie

Clinical course and differential diagnosis of thrombotic microangiopathy

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Zusammenfassung

Hintergrund

Thrombotische Mikroangiopathien sind komplexe Krankheitsbilder, die eine zeitnahe Differenzialdiagnose und Therapieeinleitung erfordern.

Fragestellung

Darstellung von klinischem Bild und diagnostischem Vorgehen, Diskussion von zugrunde liegender Pathophysiologie, klinischem Management und Therapie.

Material und Methode

Zusammenfassung des aktuellen Wissensstands aus Literatur und Expertenmeinung.

Ergebnisse

Pathophysiologisches Verständnis und Therapieoptionen haben sich zum Teil grundlegend geändert. Eine zeitnahe Differenzialdiagnose und Einleitung einer zielgerichteten Therapie ist prognostisch entscheidend.

Schlussfolgerung

Ein besseres Verständnis pathophysiologischer Zusammenhänge, eine gesteigerte klinische Vigilanz und spezifischere Therapieoptionen ermöglichen Patienten mit thrombotischer Mikroangiopathie heute eine bessere Prognose.

Abstract

Background

Thrombotic microangiopathies are complex diseases, requiring early differential diagnosis and targeted intervention.

Objectives

Presentation of clinical phenotype and diagnostic algorithm, discussion of underlying pathophysiology, clinical management and therapy.

Methods

Summary of current knowledge from literature and expert opinion.

Results

Our understanding of pathophysiology and therapeutic options have changed substantially in recent years. Early differential diagnosis and targeted therapy are of prognostic relevance.

Conclusions

A better understanding of underlying pathophysiology, increased clinical awareness and novel therapeutic options allow for a better prognosis of patients with thrombotic microangiopathy.

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Authors and Affiliations

  1. Medizinische Klinik IV, Abteilung für Endokrinologie und Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Universitätsklinikum Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Deutschland

    M. Guthoff &  N. Heyne

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  1. M. Guthoff
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Correspondence to M. Guthoff.

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Interessenkonflikt

M. Guthoff erhielt Honorare und Reisekostenunterstützung von Alexion sowie Reisekostenunterstützung von Astellas, Novartis und Pfizer. N. Heyne erhielt Honorare und Reisekostenunterstützung von Alexion, Astellas, Baxter, Hexal, Novartis, Roche und TheBindingSite.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Guthoff, M., Heyne, N. Klinik und Differenzialdiagnose der thrombotischen Mikroangiopathie. Med Klin Intensivmed Notfmed 113, 293–298 (2018). https://doi.org/10.1007/s00063-016-0193-5

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