Microangiopathy
| Classification according to ICD-10 | |
|---|---|
| I79.2 * | Peripheral angiopathy in diseases classified elsewhere |
| M31.1 | Thrombotic microangiopathy |
| I67.9 | Cerebrovascular disease, unspecified |
| ICD-10 online (WHO version 2019) | |
A microangiopathy (from ancient Greek ἀγγεῖον angeion , German 'vessel' and πάθος pathos , German 'pain' ) is a disease of the small blood vessels , usually a special form of arteriosclerosis . There is no clear boundary to macroangiopathy (arteriosclerosis of the larger arteries ); in general, the term microangiopathy is used for small vessels from the arterioles to the capillaries .
The term is often used in connection with diabetes mellitus , arterial hypertension and other metabolic diseases that lead to deposits and changes in the smallest arterial vessels.
In most cases of arteriosclerosis, micro- and macroangiopathic changes can be detected together. Pure microangiopathy is rare.
Atherosclerotic (mostly diabetic) microangiopathy is very common, but often goes unnoticed at first.
There is also the rare thrombotic microangiopathy . This term describes syndromes with microangiopathic hemolytic anemia , thrombocytopenia and thrombotic occlusions in the microcirculation. Depending on the symptoms, they are known as thrombotic-thrombocytopenic purpura ( Moschcowitz syndrome ) or hemolytic-uremic syndrome (HUS) (see also uremia ).
Vascular areas
All vascular regions of the body can be affected by microangiopathy. In particular, the fundus , the brain , the heart and the kidneys are preferred areas for microangiopathic changes:
- Kidneys
- eyes
- heart
- brain
- Feet
Diagnosis
The microangiopathy can only be recognized under the microscope or by reflecting the fundus. There are also indirect indications that point to microangiopathic changes, such as low protein loss via the kidneys or disorders of the vascular regulation of the leg vessels.
- Reflection of the fundus
- Nail bed microscopy
- Review of vascular regulation
- Microalbumin in the urine
consequences
- blindness
- Renal failure
- Chronic neurological deficits due to subcortical arteriosclerotic encephalopathy
- Heart failure as a result of chronic circulatory disorders and muscle destruction
- gangrene
therapy
- See atherosclerosis therapy
- Laser therapy for diabetic retinopathy
- A number of drugs, such as calcium dobesilate , are marketed for the specific treatment of microangiopathy. The effectiveness of calcium dobesilate was u. a. detected in patients with diabetic retinopathy or diabetic nephropathy.
Individual evidence
- ↑ XinYuan Zhang, Wei Liu, ShanShan Wu, JingLong Jin, WeiHong Li: Calcium dobesilate for diabetic retinopathy: a systematic review and meta-analysis . In: Science China Life Sciences . tape 58 , no. 1 , December 20, 2014, ISSN 1674-7305 , p. 101-107 , doi : 10.1007 / s11427-014-4792-1 (English, springer.com [accessed August 13, 2018]).
- ↑ Hermann Haller, Linong Ji, Klaus Stahl, Anna Bertram, Jan Menne: Molecular Mechanisms and Treatment Strategies in Diabetic Nephropathy: New Avenues for calcium Dobesilate-Free Radical Scavenger and growth factor inhibition . In: BioMed Research International . tape 2017 , 2017, ISSN 2314-6133 , p. 1–11 , doi : 10.1155 / 2017/1909258 , PMID 29082239 , PMC 5634607 (free full text) - (English).
