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# Hemolytic Anemia ## Causes Hemolytic anemia can be caused by: - **Congenital:** - Defects in membrane skeleton proteins - Defects in enzymes involved in energy production - Hemoglobin defects - **Acquired:** - Immune-mediated - Non-immune-mediated ## Classification These c...

# Hemolytic Anemia ## Causes Hemolytic anemia can be caused by: - **Congenital:** - Defects in membrane skeleton proteins - Defects in enzymes involved in energy production - Hemoglobin defects - **Acquired:** - Immune-mediated - Non-immune-mediated ## Classification These causes can be further broken down into: ### Inherited #### **Membrane Defects:** - **Hereditary Spherocytosis (autosomal dominant):** - **Elliptocytosis (autosomal dominant):** #### **Enzyme Defects:** - **G6PD deficiency (X-linked):** - **Pyruvate kinase deficiency (autosomal recessive):** ### Acquired #### **Hemoglobinopathy:** - **Sickle cell disease (autosomal recessive):** - **Thalassaemia:** #### **Alloimmune Hemolysis:** - **Hemolytic disease of newborn:** - **Hemolytic transfusion reaction:** #### **Autoimmune Hemolytic Anemia (AIHA):** - **Warm AIHA:** Idiopathic, CLL, lymphoma, drugs, autoimmune eg. SLE - **Cold AIHA:** Mycoplasma, infectious mononucleosis - **Paroxysmal cold haemoglobinuria:** #### **Non-Immune Mediated** - **Mechanical trauma:** Prostheses - **Microangiopathic hemolytic anemia (MAHA):** HUS, TTP, DIC - **Infections:** Malaria, clostridium - **Renal disease** - **Drugs & chemicals** - **Hypersplenism** ## Laboratory Findings - **Polychromasia:** Usually prominent (reticulocytes seen in the stained films as bluish macrocytes) - **Normoblasts:** May be present - **Spherocytes:** Suggest hereditary spherocytosis (HS) or autoimmune hemolysis - **Schistocytes (red cell fragments):** Suggest microangiopathic hemolytic anemia - **Sickle cells or target cells:** Suggest a hemoglobinopathy. - **When hemolytic anemia is acute, there is also leukocytosis with shift to the left (release of younger forms from marrow) and thrombocytosis with both normal and giant platelets** **Note:** The image also has a legend which is not fully visible. However, the abbreviations included are: - HUS: Haemolytic uraemic syndrome - TTP: Thrombotic thrombocytopenic purpura - DIC: Disseminated intravascular coagulation - CLL: Chronic lymphocytic leukemia