26 - MAHA

KYJ26 - MAHA Microangiopathic Haemolytic Anaemia.

I love big medical words or long Latin terms that sound cool but are really very simple.  I'm such a geek that way.

A recent post on the snakebite condition VICC (KYJ25), prompted today's post.

Microangiopathic haemolytic anaemia is a condition seen in snakebites where coagulation is disrupted. In Australia this is almost exclusively Brown snakes.

It is literally the cutting up of red blood cells in the smallest peripheral blood vessels.
Microangiopathic (very small blood vessel disease) haemolytic (blood cutting or splitting) anaemia (literally without blood).

MAHA is caused during a disease that causes clotting and coagulation in the capillary beds in tissues and organs.  When fibrin clots form these fine stringy strands of mesh "dam" up the small blood vessels and as blood tries to squeeze past these fibrin strands they get shredded into fragments. It doesn't just happen to RBCs , but platelets and white blood cells causing "thrombocytopenia" and "leukopenia" respectively.

With wide spread RBC destruction, there exists, an anaemia and subsequent reduction in oxygen transport.

MAHA is most common in Aortic Stenosis where the stiff aortic valve fractures and breaks blood cells being ejected with force from the heart's left ventricle.

It is always present in a Disseminated Intravascular Coagulation (DIC), and as such the cellular debris that is left in the blood vessels as a result of MAHA, may lead to death by multiple organ dysfunction syndromes (previously called "multi-organ failure").

Summary:
MAHA is a haemolytic anaemia seen in the context of Brown snake bites, where fibrin destroys blood cells squeezing past clots.