Malignant Hypertension-Induced Microangiopathic Hemolytic Anemia and Acute Kidney Injury: A Case Report

Abstract

Malignant hypertension (MH) is a medical emergency characterized by severe blood pressure elevation and end-organ damage. We present the case of a 34-year-old male with MH leading to microangiopathic hemolytic anemia (MAHA) and acute kidney injury (AKI), a rare and life-threatening combination. The patient exhibited severe hypertensive retinopathy, thrombocytopenia, and hemolysis, complicated by renal dysfunction. Diagnosis was confirmed through clinical, laboratory, and imaging findings. Multidisciplinary management, including antihypertensive therapy and supportive care, was crucial in stabilizing the patient. While features of MAHA are seen in malignant hypertension patients the full triad of malignant hypertension with clinically significant MAHA and AKI / biopsy-proven TMA is quite rare, with only a few cases reported in the literature to date. This case highlights the rarity and severity of MH with MAHA and AKI and emphasizes that rapid blood pressure control and early, coordinated multidisciplinary care are essential to prevent irreversible organ damage and improve outcomes.