Secondary Thrombotic Microangiopathy (TMA) in children- A Central Role for the Glycocalyx

The authors investigate the role of the endothelial glycocalyx (eGC) in the pathogenesis of secondary thrombotic microangiopathy (TMA) in children, which is more prevalent than primary TMA and often linked to specific diseases or triggers. They propose that damage to the eGC may serve as a critical mechanism connecting various triggers, such as infections and medications, to endothelial injury and complement dysregulation. This review highlights the potential for eGC restoration as a therapeutic target and the need for further research to identify which pediatric patients may benefit from complement blockade.