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Thrombotic microangiopathy is marker for TTP/HUS as well as for DIC/DIC-like (secondary thrombotic microangiopathy-TMA), this giving us a first overlapping area.
ADAMTS 13 (ADAMTS 13 Ab/ADAMTS 13 relative or absolute deficiency) - a recent marker for TTP, regulatory complement factors flaws (CFH, MCP-CD46, IF and CD46 Ab, CFH Ab as well)-pathogenetic elements in D- HUS, increased PAI 1-recently proved for TTP, all of this are nowadays valid pathogenetic lego bricks in that wall we call secondary TMA, this giving us our second overlapping area.
Plasma exchange, grade IA recommendation for “true” TTP, has been gaining a place in the last decade in the supportive basket for secondary TMA(e.g., sepsis ), this giving us a third overlapping area.
At least three overlapping areas and the lack of certain particular cases (malignant hypertension, HCT related TMA, D+ HUS early years) deliver us a syndrome (TMA) likely to be highly responsive to plasma exchange and, in certain situations, to tailored corticotherapy, monoclonal CD20 Ab, C5 Ab.