See also [[Anaemia]], [[haemolytic anaemia]] > Microangiopathic hemolytic anemia is a direct [[Coombs test| antibody test-negative]] intravascular hemolysis caused by excessive shear or turbulence in the circulation. → fragmented RBCs (eg, triangles, helmet shapes) called *schistocytes*. Cause ↑ RBC distribution width Disease of small blood vessels, resulting in haemolytic anaemia due to factors in small blood vessels. See *schistocytes* on blood film. In all causes, ==the mechanism of MAHA is the formation of a fibrin mesh due to increased activation of the system of coagulation.== The red blood cells are physically cut by these protein networks. **The resulting fragments are the schistocytes observed in light microscopy** Some MAHAs are associated with [[thrombocytopaenia]] # causes - [[DIC]] - [[Pre-eclampsia#HELLP]] - [[Thrombotic Thrombocytopaenic purpura|TTP]] - [[Haemolytic uraemic syndrome|HUS]] - Cancer - Malignant hypertension - cancer - Antiphospholipid syndrome - Chemo - Polarteritis nodosa - Granulomatosis with polyangiitis # treatment *Platelets and cryoprecipitate are contraindicated* as they facilitate further clot formation and RBC lysis. Plasmapheresis is one treatment for TTP; corticosteroids should also be considered.