Jun 16, 2025, 09:37
Methamphetamine Abuse Triggers Severe Thrombotic Microangiopathy
Sanjeev Sethi, Professor of Pathology and Renal Pathologist at Mayo Clinic, shared a clinical case on X.
“Methamphetamine abuse=severe thrombotic microangiopathy
Unfortunate weekend case. Glomeruli: mesangiolysis and ischemic changes
Interstitium: Hemorrhage, inflammation & scarring
Vessels: Severe sclerosis, thrombosis, schistocytes40-yr woman, hypertension, AKI, meth abuse”
In this biopsy from a 40-year-old hypertensive patient with acute kidney injury and chronic methamphetamine use, histology revealed:
- Glomeruli: marked mesangiolysis and ischemic collapse
- Interstitium: extensive hemorrhage, inflammatory infiltrates, and fibrosis
- Vessels: complete arterial occlusion, widespread thrombosis, and vascular sclerosis, with schistocyte formation
This case underscores the devastating microvascular injury drugs like methamphetamine can inflict, mimicking classic thrombotic microangiopathy. Early recognition of drug-induced TMA is critical—prompt discontinuation of the offending agent and supportive care may improve renal outcomes.
Stay up to date with Hemostasis Today for more case reviews.
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