Sunday, 31 October 2010

MRCP revision battle 38.6: Microangiopathic haemolytic anaemia

Microangiopathic haemolytic anaemia (MAHA) is a nice condition to learn about as you can easily visualise it: it is mechanical disruption of red blood cells in the circulation, so in your mind's eye see the little RBC's being mangled by prosthetic heart valves or sliced by fibrin strands and then imagine them on the other side, reduced in number (anaemia), all with different amounts of haemoglobin in them after being sliced (polychromasia) and lots of partial fragments (schistocytes and helmet cells).

So to put that above paragraph into a nice list of haematological features of MAHA:
  • anaemia
  • polychromasia
  • helmet cells
  • schistocytes

Causes of MAHA include:
  • DIC
  • HUS
  • TTP
  • malignant hypertension
  • severe pre-eclampsia
  • prosthetic heart valves
  • septocaemia

Now onwards to the last MRCP revision battle of the day, sideroblastic anaemia...