Thrombotic Microangiopathy (TMA)

Thrombotic microangiopathy (TMA) is a disease that includes decreased kidney function, low platelet counts and low red blood cell counts that can be inherited or acquired.  A wide range of conditions and medications can influence how likely this syndrome may happen.  Thrombotic microangiopathy can damage tiny blood vessels in your kidneys and other organs and can lead to kidney disease and kidney failure.  

This an exciting time in TMA treatment.  We now understand several of the pathways that can lead to TMA and can offer treatment directed at stopping those pathways including plasmapheresis treatments, medications that inhibit the complement pathway (eculizumab, ravulizumab) and others that decrease the production of antibodies that cause TMA.

It is challenging to tell the different forms of TMA apart from each other and to decide on the right treatment. The best diagnosis and treatment requires a multidisciplinary team approach, including clinicians from a variety of backgrounds.  At Tufts Medical Center, our multidisciplinary TMA team carefully assesses the potential causes of TMA in each patient and works together to agree on the correct treatment.  Dr. Gordon leads the TMA team at Tufts Medical Center. He has extensive experience in diagnosing and treating patients with TMA. He helped create the TMA team idea and has lectured extensively around the world describing the role of a multidisciplinary team approach to TMA.  TMA team members include Hematologists, Nephrologists, Blood Bank specialists, Pharmacologists and several other medical specialists who work together to provide you the individualized care to manage your symptoms and take control of your health.

We are also excited that there are several ongoing studies looking at new treatments. As new treatments become available, patients will have more options for what is best for their own health and life goal

Our goal is to give each patients a lifetime of individualized care.  We help patients understand what is known and what is not known about their disease and treatments so they can make the best decision for them.  We understand what it's like to live with kidney disease.  Dr. Gordon and his team are dedicated kidney doctors who can help you and your family live your life with kidney disease.
 

Services:

  • Multidisciplinary TMA team approach
  • Comprehensive, multidisciplinary care for all forms of TMA
  • Review of peripheral blood smear
  • Kidney biopsy and interpretation in TMA cases
  • Use of latest diagnostic algorithms to determine cause of TMA
  • Skin biopsy for c5-9 (MAC) testing under development
  • Urgent access to complement inhibitor therapies
  • Urgent access to plasmapheresis therapies
  • Genetic testing of complement system, counseling and family planning
  • Management of TMA in pregnancy and post-partum
  • Dialysis services, including access surgery
  • Kidney transplantation and donor-matching services
 

Programs + Services


Nephrology

The Division of Nephrology at Tufts Medical Center in Boston specializes in the study, diagnosis and treatment of kidney disease and high blood pressure and more.
More information about programs and services


Center for Glomerular Disease

Our Glomerular Disease clinic is a multi-disciplinary clinic designed to provide comprehensive diagnosis and treatment of kidney glomerular disorders. We will use an evidence–based approach combined with individualized decision making to take care of you.
More information about programs and services

Doctors + Care Team

Craig E. Gordon, MD, MS

Craig E. Gordon, MD, MS

Accepting New Patients

Virtual Appointments Available

Title(s): Nephrologist; Associate Professor of Medicine, Tufts University School of Medicine
Department(s): Medicine, Nephrology
Appt. Phone: 617-636-5866
Fax #:

Polycystic kidney disease (PKD), hepatitis C virus in chronic kidney disease, Thrombotic microangiopathy, glomerular disease, kidney transplantation, chronic kidney disease

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Dana C. Miskulin, MD, MS

Dana C. Miskulin, MD, MS

Accepting New Patients

Virtual Appointments Available

Title(s): Nephrologist; Associate Professor, Tufts University School of Medicine
Department(s): Medicine, Nephrology
Appt. Phone: 617-636-5866
Fax #: 617-636-2369

Polycystic kidney disease (PKD), dialysis, home dialysis, general nephrology, chronic kidney disease (CKD), diabetic kidney disease, glomerular disease, vasculitis, hypertension, cardiovascular disease in patients with kidney disease, acute kidney disease, acute kidney injury and kidney stones

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David Drew, MD, MS

David Drew, MD, MS

Accepting New Patients

Title(s): Nephrologist; Assistant Professor of Medicine, Tufts University School of Medicine
Department(s): Medicine, Nephrology
Appt. Phone: 617-636-5866
Fax #: 617-636-2369

General nephrology, chronic kidney disease (CKD), diabetic kidney disease, glomerular disease, vasculitis, hypertension, cardiovascular disease in patients with kidney disease, acute kidney disease, acute kidney injury, kidney stones and monoclonal gammopathy of renal significance

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Lesley A.  Inker, MD, MS

Lesley A. Inker, MD, MS

Accepting New Patients

Virtual Appointments Available

Title(s): Director, Kidney and Blood Pressure Center; Director, Kidney Function and Evaluation Center; Director, Quality Improvement; Associate Professor, Tufts University School of Medicine
Department(s): Medicine, Nephrology
Appt. Phone: 617-636-5866
Fax #: 617-636-2369

Geriatric nephrology, pregnancy, HIV-associated kidney disease, kidney transplantation, kidney donor evaluation, medical treatment for kidney failure without dialysis, kidney function evaluation (GFR), general nephrology, chronic kidney disease (CKD), diabetic kidney disease, glomerular disease, vasculitis, hypertension, cardiovascular disease in patients with kidney disease, acute kidney disease, acute kidney injury and kidney stones

View Full Profile for Lesley A. Inker, MD, MS