A child with anemia, thrombocytopenia, renal failure and elevated amylase, and lipase enzymes: Answers

  • Neslihan GünayEmail author
  • Ayşe Seda Pınarbaşı
  • İsmail Dursun
  • Sibel Yel
  • Muammer Hakan Poyrazoğlu
  • Ruhan Düşünsel
Clinical Quiz

What is your diagnosis?

Thrombotic microangiopathy (TMA) should be considered in this patient with a decrease in urinary output, deterioration of renal function tests, thrombocytopenia, and findings consistent with hemolysis in peripheral blood spread.

Thrombotic microangiopathies describe a group of diseases with clinic of anemia, thrombocytopenia, and acute renal failure. These diseases classified as the name hemolytic uremic syndromes (HUS). The common pathological features in these diseases, endothelial cell injury, microthrombus formation, and multiorgan injury [1].

There are multiple causes of the microangiopathies including Shiga toxin-associated HUS, complement-mediated HUS, thrombotic thrombocytopenia purpura, and other less common causes of HUS (Table 1) [ 1].
Table 1

Causes of thrombotic microangiopathies

Shiga toxin-associated HUS (ST-HUS)

Complement-mediated HUS

Thrombotic thrombocytopenic purpura (TTP)

Streptococcal/infectio-associated HUS

Cobalamin deficiency-associated...



A disintegrin and metalloprotease with thrombospondin type 1 repeats member 13


Hemolytic uremic syndrome


Interleukin 6


Interleukin 8


Thrombotic microangiopathy


Tumor necrosis factor-α


Thrombotic thrombocytopenic purpura


Ultra large von Willebrand factor


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© IPNA 2018

Authors and Affiliations

  • Neslihan Günay
    • 1
    Email author
  • Ayşe Seda Pınarbaşı
    • 1
  • İsmail Dursun
    • 1
  • Sibel Yel
    • 1
  • Muammer Hakan Poyrazoğlu
    • 1
  • Ruhan Düşünsel
    • 1
  1. 1.Department of Pediatrics, Division of NephrologyErciyes University, Faculty of MedicineKayseriTurkey

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