Manual práctico de Trombosis y Hemostasia de la SETH

— 1 3 1 — 8 . M i c r o a n g i o p a t í a s t r o m b ó t i c a s a ticlopidina se tratan con RP, dado que se asocian a Ac anti-ADAMTS13. – Las MAT por alteraciones de DGKE o plasminógeno no responden a eculizumab. La eficacia de la infusión de plasma es dudosa. Las causadas por aciduria metilma- lónica con homocistinuria o déficit de vitamina B12 se tratan con vitamina B12. – En la MAT asociada al TPH, la primera medida a to- mar es sustituir los inhibidores de la calcineurina por otros inmunosupresores (micofenolato mofetil, este- roides). Por sí sola, esta medida resuelve muchas MAT postrasplante. Se han usado diversos tratamientos de forma empírica y ninguno se ha demostrado útil. Los RP tienen una indicación de categoría III de la ASFA (no están establecidos y su indicación debe individualizarse). Algunos casos han respondido al eculizumab. BIBLIOGRAFÍA 1. Tsai HM. A mechanistic approach to the diagnosis and manage- ment of atypical hemolytic uremic syndrome. 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