Thrombotic microangiopathy (TMA) is a rare but very serious condition. It is characterized by widespread microthrombi formation in multiple organs (in its severe and disseminated form) or localized microthrombi in the kidney (in its limited form). TMA is usually characterized by thrombocytopenia, microangiopathic hemolytic anemia (MAHA), and multiple organ injury and dysfunction.
Early detection and accurate diagnosis are essential to implement appropriate therapies, and improve patients’ prognosis and survival. Delay in diagnosis could result in late implementation of appropriate therapies, and this could result in permanent and irreversible organ damage. Left untreated TMA is associated with very high level of morbidity and mortality. TMA presentation could be highly variable making the diagnosis even more difficult. Once the diagnosis of TMA is established, defining the underlying cause is even more challenging due to frequent overlap between the common causes of TMA.
We have a unique multidisciplinary approach to the management of this very rare disease. A TMA team was established at Boston University Medical Center with the primary objective of improving patients care and outcome. Our Team works in close collaboration with the ARC on Thrombosis.
A primary goal of the team is to provide excellent patient care. The TMA team is multidisciplinary involving: nephrologists, hematologists, the director of apheresis, pediatric hematologist and pharmacist. They are always available to manage any patient with suspected TMA. Special protocols and algorithm have been created by the team to help guiding the provider in making an accurate diagnosis of any TMA case.
Another goal of the TMA team is educational. We are actively spreading awareness of this rare disease between our providers at BMC, and also regionally and nationally by organizing lectures and seminars as well as mini-symposia.
A third goal of the TMA team is to advance basic and clinical research related to TMA. We are active in clinical trials addressing the efficacy of newer agents for the treatment of complement mediated HUS a special form of TMA. Our scientists are also trying to understand some underlying pathological mechanisms that could be contributing to TMA.
- Member, Evans Center for Interdisciplinary Biomedical Research, Boston University
- Lebanese University, MD
- Lebanese University, BS
- Published on 3/9/2020
Angel-Korman A, Stern L, Angel Y, Sarosiek S, Menn-Josephy H, Francis J, Ghai S, Sloan JM, Sanchorawala V, Havasi A. The Role of Kidney Transplantation in Monoclonal Ig Deposition Disease. Kidney Int Rep. 2020 Apr; 5(4):485-493. PMID: 32274452.
- Published on 2/1/2020
Addo-Tabiri NO, Chudasama R, Vasudeva R, Leiva O, Garcia B, Ravid JD, Bunze T, Rosen L, Belghasem M, Francis J, Brophy M, Johnson B, Ferguson R, Weinberg J, Chitalia VC. Black Patients Experience Highest Rates of Cancer-associated Venous Thromboembolism. Am J Clin Oncol. 2020 02; 43(2):94-100. PMID: 31809329.
- Published on 12/27/2019
Lyle C, Richards S, Yasuda K, Napoleon MA, Walker J, Arinze N, Belghasem M, Vellard I, Yin W, Ravid JD, Zavaro E, Amraei R, Francis J, Phatak U, Rifkin IR, Rahimi N, Chitalia VC. c-Cbl targets PD-1 in immune cells for proteasomal degradation and modulates colorectal tumor growth. Sci Rep. 2019 12 27; 9(1):20257. PMID: 31882749.
- Published on 12/26/2019
Belghasem M, Roth D, Richards S, Napolene MA, Walker J, Yin W, Arinze N, Lyle C, Spencer C, Francis JM, Thompson C, Andry C, Whelan SA, Lee N, Ravid K, Chitalia VC. Metabolites in a mouse cancer model enhance venous thrombogenicity through the aryl hydrocarbon receptor-tissue factor axis. Blood. 2019 12 26; 134(26):2399-2413. PMID: 31877217.
- Published on 10/30/2019
Walker JA, Richards S, Belghasem ME, Arinze N, Yoo SB, Tashjian JY, Whelan SA, Lee N, Kolachalama VB, Francis J, Ravid K, Sherr D, Chitalia VC. Temporal and tissue-specific activation of aryl hydrocarbon receptor in discrete mouse models of kidney disease. Kidney Int. 2020 Mar; 97(3):538-550. PMID: 31932072.
- Published on 5/9/2019
Belghasem ME, A'amar O, Roth D, Walker J, Arinze N, Richards SM, Francis JM, Salant DJ, Chitalia VC, Bigio IJ. Towards minimally-invasive, quantitative assessment of chronic kidney disease using optical spectroscopy. Sci Rep. 2019 05 09; 9(1):7168. PMID: 31073168.
- Published on 4/15/2019
Kannan S, Morgan LA, Liang B, Cheung MG, Lin CQ, Mun D, Nader RG, Belghasem ME, Henderson JM, Francis JM, Chitalia VC, Kolachalama VB. Segmentation of Glomeruli Within Trichrome Images Using Deep Learning. Kidney Int Rep. 2019 Jul; 4(7):955-962. PMID: 31317118.
- Published on 3/1/2019
Arinze NV, Gregory A, Francis JM, Farber A, Chitalia VC. Unique aspects of peripheral artery disease in patients with chronic kidney disease. Vasc Med. 2019 06; 24(3):251-260. PMID: 30823859.
- Published on 2/18/2019
Cohen-Bucay A, Gordon CE, Francis JM. Non-immunological complications following kidney transplantation. F1000Res. 2019; 8. PMID: 30828430.
- Published on 11/29/2018
Gordon CE, Balk EM, Francis JM. Summary of the 2018 Kidney Disease Improving Global Outcomes (KDIGO) Guideline on hepatitis C in chronic kidney disease. Semin Dial. 2019 03; 32(2):187-195. PMID: 30496617.
View 37 more publications: View full profile at BUMC