Hemolytic anemia - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Hemolytic anemia is characterized by the premature destruction of red blood cells.
Anemia, reticulocytosis, low haptoglobin, high lactate dehydrogenase, and high indirect bilirubin suggest hemolysis.
Direct antiglobulin test (Coombs) is important for differentiating immune from nonimmune etiologies. Peripheral smear review is important in identifying underlying cause.
Corticosteroids are often first-line therapy in immune-mediated cases. Discontinuation of offending agents (e.g., suspected drugs) and supportive care are the mainstay of treatment for many subtypes.
Early vaccination against encapsulated organisms is important in cases that may be treated with splenectomy.

Peripheral blood smear with spherocytes, reticulocytes, and a nucleated red blood cell

From the collection of John Densmore, Department of Medicine, University of Virginia

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History & Exam
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Peripheral blood smear with spherocytes, reticulocytes, and a nucleated red blood cell
Peripheral blood smear with red blood cell fragments, or schistocytes (arrow)
Digitally-colorized scanning electron micrograph showing normal red blood cells (RBCs) and a sickle cell RBC (left) in a blood specimen of patient with sickle cell anemia
A photomicrograph of a blood smear showing erythrocytes containing developing Plasmodium vivax parasites
Photomicrograph revealing the presence of what were determined to be numbers of intraerythrocytic Babesia sp. ring-form parasites

Citations

Key Articles

Go RS, Winters JL, Kay NE. How I treat autoimmune hemolytic anemia. Blood. 2017 Jun 1;129(22):2971-9[Abstract]
Hill QA, Stamps R, Massey E, et al. The diagnosis and management of primary autoimmune haemolytic anaemia. Br J Haematol. 2017 Feb;176(3):395-411.[Abstract][Full Text]
Hill QA, Stamps R, Massey E, et al. Guidelines on the management of drug-induced immune and secondary autoimmune, haemolytic anaemia. Br J Haematol. 2017 Apr;177(2):208-20.[Abstract][Full Text]

Referenced Articles

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