How I treat thrombotic microangiopathy in the setting of triggers.

Complement-mediated thrombotic microangiopathy can be effectively identified and managed despite confounding clinical triggers, with urgent complement blockade preventing irreversible kidney damage.

• Why it matters: Accurate recognition of this condition is crucial because triggers like pregnancy or hypertension can mask underlying complement dysregulation, risking delayed treatment and kidney failure.
• What they did: Using three real-world cases, the authors demonstrate a practical approach that considers kidney injury patterns, disease progression, and response to supportive care, alongside genetic and functional assessments.
• The result: This approach enables tailored treatment decisions, emphasizing timely complement blockade when indicated, and highlights the importance of individualized management to improve patient outcomes.