The Malignant Hypertension-Thrombotic Microangiopathy Link
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To the Editor:
The article by van den Born et al1 nicely demonstrates the reduction in ADAMTS-13 levels in patients with malignant hypertension. This study is further proof that low levels of this enzyme are more a marker of endothelial dysfunction rather than of thrombotic microangiopathy (TMA). Endothelial dysfunction also causes a reduction of NO, which is an important role player in the pathogenesis of both malignant hypertension and TMA.2,3
Patterson et al2 demonstrated that superoxide anion contributes to the pathogenesis of various forms of hypertension, including malignant hypertension, through a mechanism that is NO dependent. Increased …