Thrombotic microangiopathy (TMA) is a rare but potentially life threatening condition that affects the body’s small blood vessels. TMA occurs in about 1 to 3 people out of 1 million.

It can be hereditary, but it can also be caused by certain illnesses or medications.

The outlook for someone with the condition depends on the underlying cause of the disease.

The causes, symptoms, treatment, and prognosis of the disease will be covered in this article.

The term refers to a clot in the body. Microangiopathy is a medical condition affecting small blood vessels. Blood clot formation is a condition in which those blood vessels are damaged.

However, TMA also causes a reduction in circulating platelets because the blood clots are made of platelet clumps. The associated destruction of red blood cells is called hemolytic anemia.

The brain and the kidneys are the most likely to experience TMA, which can lead to problems with organ function.

There are several types of TMA. There are two more common versions of the disease.

Thrombocytopenic purpura (TTP)

TTP occurs when there is low activity of the protein ADAMTS13. This protein is involved in the regulation of blood clotting.

In some cases, a person is born with a mutation in the gene ADAMTS13. Other people with TTP develop a type of autoimmune disorder that interferes with the activity of the ADAMTS13 gene.

Hemolytic uremic syndrome (HUS)

HUS often develops after a serious bowel infection, typically caused by the bacteria E. coli. This type of TMA primarily affects the small blood vessels of the kidneys.

The part of the body affected by the disease is the most affected by the disease. A person with low platelet counts is more likely to have bleeding problems.

Symptoms can include low red blood cell counts.

A person can have an abnormal kidneys when they are involved. High blood pressure could be a symptom. If they are diagnosed with TTP, they may have a fever.

Symptoms can include blood vessels in the brain.

  • There is confusion.
  • It is daytime.
  • Seizures.

A person with the disease may have a primary form of it, which means it developed on its own and not as a result of another cause.

Secondary forms of the disease are when there is an underlying cause that causes the disease. Most of the cases are secondary.

There are a number of common causes of thrombotic microangiopathy.


In a 2019 study involving more than 500 individuals with TMA, researchers determined that 35 percent of the cases were associated with pregnancy. According to research, pregnancy-related TMA is usually characterized by:

  • a breakdown of red blood cells (hemolysis)
  • elevated liver function.
  • Low platelet count syndrome is a condition.


Both viral andbacterial infections can cause problems. There are viral infections.

An E. coli infection remains the most common bacterial infection known to cause TMA.


A review of more than 600 TMA studies suggests that the mechanism behind drug-induced TMA isn’t well understood. However, there are several drugs particularly associated with the disease. These include:


Cancer-related TMA can be caused by a cancer itself or by treatment with drugs such as mitomycin C.

A 2016 review of research suggests that TMA originating from cancer treatment drugs may be more serious and that the prognosis is more encouraging when TMA develops as a result of the underlying cancer.

Malignant hypertension, which is sudden, abnormally high blood pressure, is also a known contributor to TMA.

Other causes include:

The nature of the disease is what determines the right treatment for the disease. TTP is often treated with a blood product. The removal of water, salts, and enzymes from the blood is involved. You will receive fresh donor blood to replace what was removed.

With hemolytic uremic syndrome (HUS), intravenous fluids and nutritional supplements may be sufficient. Blood transfusions may be necessary to reduce symptoms and prevent future complications.

If kidney damage is severe, dialysis may be necessary on a temporary basis to maintain kidney function and help resolve TMA.

The cause of the TMA is what determines other treatments. Antibiotics may be prescribed if a bacterial infection is detected. Immune suppression therapies may be needed for an auto Immune disorder

The survival rates for TMA are associated with so many different possible causes and can take on several different forms.

A 2021 study involving 239 people suggests that the overall mortality rate during the 11-year follow-up period was 23 percent.

It should be noted that TMA cases triggered by cancer and other malignancies are more likely to have a poorer outlook than those diagnosed during pregnancy.

The outlook for TTP depends on whether you get treatment.

The Thrombotic Thrombocytopenic Purpura Foundation suggests that without treatment, 95 percent of individuals with TTP may die from the disease. With treatment, up to 90 percent of people can achieve remission, though nearly one-third may relapse.

The National Kidney Foundation reports that about 85 percent of common HUS cases resolve completely. However, if there was significant kidney damage, some kidney problems and high blood pressure may be more likely later on.

TMA is a disease that can be caused by blood clot in the smallest blood vessels in the body, such as the brain and the kidneys. A health condition or pregnancy can cause the problem.

Blood transfusions, plasma exchange, and other treatments are possible for the treatment of the disease.

This rare blood disorder is often treated with a proper diagnosis and prompt treatment. Monitoring after treatment is important to keep the TMA from returning and causing more problems.