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Hemolytic Anemias

Intravascular hemolysis
1. Paroxysmal nocturnal hemoglobinuria
  1. Missing CD55 and CD59
  2. Positive Ham's test
2. Autoimmune hemolytic anemia
3. Mechanical destruction
Extravascular hemolysis
1. Hereditary spherocytosis
  1. Ankyrin
  2. Spectrin
  3. Increased MCHC and RDW
  4. Splenomegaly
  5. Aplastic crises due to parvovirus B19
  6. Osmotic fragility test
  7. Splenectomy
2. G6PD deficiency
  1. Sensitive to oxidative stress
    1. Sulfa drugs
    2. Fava beans
    3. Infections
  2. Heinz bodies
3. Pyruvate kinase deficiency
  1. RBCs cannot generate ATP
  2. Swelling and hemolysis of the red cells
4. Sickle cell disease
  1. Low oxygen tension
  2. Dehydration
  3. Complications
    1. Sequestration crisis
    2. Autosplenectomy
    3. Salmonella osteomyelitis
    4. Aplastic criss due to parvovirus B19
    5. Pain crises due to vasoocclusion
    6. Renal papillary necrosis due to hypoxemia
  4. Treatment
    1. Hydroxyurea
    2. Bone marrow transplantation
5. Hemoglobin C disease
  1. Heterozygous: asymptomatic
  2. Homozygous: mild hemolysis and splenomegaly
  3. SC disease
Warm agglutinins (IgG antibodies)
1. Lupus
2. CLL
3. Drugs
Cold agglutinins (IgM antibodies)
1. CLL
2. Mycoplasma infections
3. Infectious mononucleosis

Hemolytic Anemias

	Created by snlogel over 10 years ago