Thrombotic Microangiopathic Hemolytic Anemia without Evidence of Hemolytic Uremic Syndrome

In a recent issue of this journal Dr. Oymak and her colleagues\udpresented a clinically and genetically well-studied 5-year-old\udboy who was seen with severe microangiopathic hemolytic\udanemia without laboratory findings of renal involvement\uddespite complement factor H gene mutations [1].\udBecause of Yeneral’s extensive review [2] on atypical hemolytic\uduremic syndrome (aHUS) published recently in the Turkish\udJournal of Hematology, I brought it to readers’ attention that\udmore recently some authors do not use ‘aHUS’, which was\udhistorically used to distinguish heterogeneous uncharacterized\udsyndromes from Shiga toxin-related HUS, since the term lacks\udboth specificity and suggested causes [3].\udThough in our patient with thrombotic thrombocytopenic\udpurpura renal involvement was documented at the beginning\udbut not in the last two recurrences, neither serum nor urinary\udfindings indicated kidney involvement [4].\udAlthough the discussions of Dr. Oymak et al. are well taken,\udthe term ‘microangiopathic hemolytic anemia’ is covering the\udsyndrome to a large extent as suggested by George and Neste