Microangiopathic hemolytic anemia (MAHA) occurs when turbulence in the blood destroys red blood cells. This leads to symptoms such as tiredness and shortness of breath. Certain treatments are available.

Treatment for MAHA can range from blood transfusion to the use of antibiotics.

This article details the diagnosis and treatment of MAHA, including its involvement in hemolytic uremic syndrome, causes, and symptoms.

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MAHA is a condition that involves the destruction of too many red blood cells. This process is known as “hemolysis.”

MAHA occurs when excessive movement of the blood causes hemolysis. This results in the formation of schistocytes, which are fragments of red blood cells. Whole red blood cells have a round shape, whereas schistocytes are triangle- or helmet-shaped.

Triad of microangiopathic hemolytic anemia

Several health conditions involve MAHA. One of these is hemolytic uremic syndrome.

As a 2023 reviewTrusted Source explains, hemolytic uremic syndrome involves the following triad of conditions:

Microangiopathic hemolytic anemia vs. disseminated intravascular coagulation (DIC)

Disseminated intravascular coagulation (DIC) is also a condition that affects the blood. However, it does not involve the destruction of red blood cells.

Instead, the National Institutes of Health (NIH)Trusted Source characterizes DIC as a blood clotting disorder.

In its first phase, overacting clotting mechanisms cause blood clotting throughout the body. In its second phase, bleeding develops because the body has overused blood clotting resources, such as platelets and clotting factors.

The following conditions can cause MAHA:

Autoimmune conditions that can cause microangiopathic hemolytic anemia

Systemic rheumatic diseases are autoimmune conditions that cause long-term (chronic) inflammation. Some such conditions can cause MAHA. These include:

Drugs that can cause microangiopathic hemolytic anemia

Some recreational drugs can cause MAHA. Plus, research has shownTrusted Source that some medications can cause MAHA. These include:

  • antiplatelet drugs
  • immunosuppressants
  • estrogen-containing birth control

According to a 2024 article, the red blood cell destruction in MAHA causes anemia.

Symptoms of anemia include:

  • fatigue
  • weakness
  • fainting
  • shortness of breath

Other symptoms of MAHA depend on its underlying cause or accompanying disease. For instance, researchers have documentedTrusted Source the following symptoms of hemolytic uremic syndrome:

Anyone with symptoms of hemolytic uremic syndrome requires urgent medical attention.

The treatment for MAHA depends on its underlying causes. For example, research supportsTrusted Source the use of the following treatments for hemolytic uremic syndrome:

  • increasing volume of lost bodily fluids
  • blood transfusions
  • blood plasma transfusion
  • platelet transfusions
  • the antibody eculizumab

Doctors may recommend similar MAHA treatments for people with cancer. One difference is that in people with cancer, certain antivirals and antibiotics may be more appropriate.

Because MAHA is a blood disorder, doctors can diagnose it with blood tests. However, research showsTrusted Source that it is also important to diagnose the cause or underlying condition of MAHA. These include the following tests:

  • ADAMTS13 enzyme blood test
  • ADAMTS13 enzyme inhibitor blood test
  • complement factor protein blood test
  • Shiga toxin stool test

What is the life expectancy of someone with hemolytic anemia?

The life expectancy for people with MAHA varies depending on its causes and other related conditions. For instance, in the context of thrombotic thrombocytopenic purpura, the post-treatment mortality rate is 10% to 15%Trusted Source.

What is the most common cause of hemolytic anemia?

Scientists are uncertain about the most common cause of hemolytic anemia.

MAHA is when too much blood movement destroys red blood cells, causing schistocytes. This can arise in the context of hemolytic uremic syndrome, a triad of conditions that also involve thrombocytopenia and acute kidney injury.

Blood and stool tests can help to diagnose both MAHA and its causes. Symptoms are similar to those of anemia, alongside those of the accompanying conditions.

Doctors can help treat MAHA with fluid replacements, blood transfusions, and antibodies.