Fatal microangiopathic hemolytic anemia: Two case reports

Abstract

The microangiopathic hemolytic anemia (MAHA) characterizing hemolytic anemia with fragmented red blood cells (RBCs) in the peripheral blood smears. Hemolytic Uremic Syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) are classified under MAHA. We report two cases who presented to emergency room (ER), a 7-year-old female child who was diagnosed with atypical HUS with malignant hypertension on the basis of classic triad of hemolytic anemia, thrombocytopenia, and acute kidney injury. Second case was a 45-year-old female presented with altered sensorium, fever, and multiorgan failure. And finally diagnosed as TTP. Both the cases partially treated at private nursing home initially for few days and then referred to our hospital. This case report emphasizes the importance of correlation of emergency and laboratory physicians’ findings to approach a case of MAHA. As delay in early recognition of these conditions resulting in fatal outcome.

Keywords

• Blood films schistocytes
• Hemolytic Uremic Syndrome
• microangiopathic hemolytic anemias
• thrombotic thrombocytopenic purpura