Piero Ruggenenti, Marina Noris, Giuseppe Remuzzi Kidney International

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Presentation transcript:

Thrombotic microangiopathy, hemolytic uremic syndrome, and thrombotic thrombocytopenic purpura Piero Ruggenenti, Marina Noris, Giuseppe Remuzzi Kidney International Volume 60, Issue 3, Pages 831-846 (September 2001) DOI: 10.1046/j.1523-1755.2001.060003831.x Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 1 A suggested sequence of events leading to thrombotic microangiopathy in predisposed individuals exposed to triggers of vascular injury. Genetic predisposition may have a predominant role in familial and recurrent forms, exposition to triggers of vascular injury in Shiga toxin E. coli-associated HUS. Kidney International 2001 60, 831-846DOI: (10.1046/j.1523-1755.2001.060003831.x) Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 2 Glomerulus from a patient with a form of HUS with predominant glomerular involvement. Capillary lumina are narrowed or occluded by erythrocytes and thrombi. Swelling of endothelial cells and thickening of the capillary wall with double contours have also occurred. A marked thickening of the glomerular capillary wall occurs with many double contours. Kidney International 2001 60, 831-846DOI: (10.1046/j.1523-1755.2001.060003831.x) Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 3 Two arterioles in a case of atypical HUS with severe vascular involvement. The vascular lumen is extremely narrowed due to miointimal proliferation and vascular wall thickening. Kidney International 2001 60, 831-846DOI: (10.1046/j.1523-1755.2001.060003831.x) Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 4 Glomerulus from a patient with atypical HUS with predominant vascular involvement. Severe ischemic changes have occurred, characterized by marked restriction of the glomerular tuft. Kidney International 2001 60, 831-846DOI: (10.1046/j.1523-1755.2001.060003831.x) Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 5 A glomerulus and an interlobular artery from a patient with atypical HUS with severe vascular involvement. Severe ischemic changes have occurred with marked glomerular restriction and concomitant severe tubular changes. The vascular lumen is almost entirely occluded due to extreme thickening of the vascular wall. Kidney International 2001 60, 831-846DOI: (10.1046/j.1523-1755.2001.060003831.x) Copyright © 2001 International Society of Nephrology Terms and Conditions