Figure 3
The upper part of figure 3 summarizes the concept of Timmermans et al..
Measurement of exvivo formation of C5b-9 on endothelial cells and
genetic screening can divide patients with hypertensive emergency and
thrombotic microangiopathy into high blood pressure or complement
mediated thrombotic microangiopathy. Malignant nephrosclerosis and aHUS
are two diseases with an overlap as shown in the lower part. On the left
hand, malignant nephrosclerosis driven primarily by high blood pressure
and on the right hand aHUS driven by complement dysfunction. In between
lies a continuum with increasing or decreasing importance of complement
dysfunction and blood pressure. Histology shows onion-like narrowing of
intrarenal vessels and ischemic glomeruli in malignant nephrosclerosis.
In case of aHUS, fresh vascular and glomerular fibrin thrombi (arrows)
are found as well as HUS glomerulopathy. Figure 3 modified from
Timmermans et al. 2020 and van Laecke et al. 2017. MG=masson goldner
staining. Histology pictures are kindly provided by T. Wiech, Hamburg,
Germany.