Identifying the presence of TMA

• Complete blood count • Peripheral smear for evaluation of schistocytes • Reticulocyte count • Bilirubin • Lactic Dehydrogenase • Haptoglobin

Evaluating the degree of organ injury

• Complete physical exam including blood pressure and neurologic assessment • Kidney function: BUN, serum creatinine • Urinalysis and proteinuria • Liver enzymes • Pancreas enzymes: amylase, lipase • Blood bicarbonate and lactic acid levels • Troponin

Defining underlying cause (request according to clinical suspicion)

• Shigatoxin in stools • ADAMTS13 activity and inhibitor • Blood complement levels • Cultures: blood, urine, CRL, empyema • Latex test for Streptococcus pneumoniae • Tests for H1N1 and COVID19 • Other infections according to epidemiology: dengue, leptospirosis • Homocysteine and vitamin B12 blood levels • Urinary amino acid chromatography • Genetic testing: complement panel or Whole Exome Sequencing • Anti-factor H antibody • Kidney biopsy when secondary cause suspected or need to evaluate chronicity

BUN blood urea nitrogen; CRL cephaloraquidic liquid; ADAMTS13 a disintegrin and metalloprotease with thrombospondin type-1 repeats, 13th member; H1N1 quick test to detect influenza strain; COVID19 antigen or antibody tests to detect current infection by SARS-CoV-2 virus