Observational studyBMC nephrology2025
Spectrum and outcomes of thrombotic microangiopathies in nephrology: a 17-year cohort from a North African center.
Observational study in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Clinical Spectrum and Differential Diagnosis of Adult Thrombotic Microangiopathies: Real-World Experience from a Tertiary Referral Center.Hematology reports · 2026Article
- Article
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Authors and funding
6 authors.
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Abstract
backgroundThrombotic microangiopathies (TMA) are rare but life-threatening conditions characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ injury. They are encountered in nephrology due to their renal manifestations. Data from North African populations remain scarce.
methodsWe conducted a retrospective observational study over 17 years (2006–2023) in a nephrology department in Tunisia. We included 36 patients with confirmed TMA based on clinical and/or histological criteria. We analyzed demographics, clinical presentations, laboratory findings, renal histology, etiologies, treatments, and outcomes.
resultsThe mean age was 35.6 ± 11.3 years, and 55.6% were female. Hypertension was present in 83.3% of cases, and neurological symptoms in 66.7%. Acute kidney injury occurred in 80.6%, with stage 3 KDIGO in most cases. Etiologies were dominated by malignant hypertension (33.3%), pregnancy-related TMA (30.6%), drug-induced TMA (13.9%), and less commonly autoimmune, infectious, or atypical/typical hemolytic uremic syndromes. Renal biopsy, performed in 12 cases, revealed acute and chronic TMA lesions. Treatments included antihypertensive therapy (86.1%), plasma exchange (16.7%), corticosteroids (22.2%), and rituximab (2.7%). No patient received eculizumab. Renal recovery varied widely by etiology, with complete recovery in 90.9% of pregnancy-related cases and none in malignant hypertension. The overall rate of adverse outcomes (death or end stage renal disease (ESRD)) was 58.3%.
conclusionTMA is a heterogeneous condition with diverse etiologies and outcomes. Early etiological identification and tailored management are crucial to improving renal prognosis, particularly in resource-limited settings where access to targeted therapies is restricted. CLINICAL TRIAL NUMBER: Not applicable.
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