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Thrombotic microangiopathy (TMA) describes a syndrome complex consisting of widespread intravascular thrombi, microangiopathic hemolytic anemia, and renal failure. Drugs are occasionally suspected of inciting this syndrome.
To examine the strength of evidence supporting the causal association of drugs with TMA, investigators performed a systematic literature review of relevant articles and categorized drug reactions as either immune-mediated or toxic.
TMA was attributed to 51 drugs causing an immune-mediated reaction and 26 drugs causing a toxic reaction. Of the 8 immune-mediated drugs with definite evidence of an association with TMA, quinine accounted for 34 cases, and muromonab-CD3, oxaliplatin, penicillin, quetiapine, sulfisoxazole, Triel…