Hemolytic anemia resident survival guide

Hemolytic anemia Resident Survival Guide
Overview
Causes
FIRE
Diagnosis
Treatment
Do's
Don'ts

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];

Overview

• Anemia is defined as a decrease in red blood cell population in the body.Hemolytic anemia results from a destruction of RBCs which is faster than the bone marrow production of them. Hemolysis can be due to either extravascular or intravascular destruction of cells.
• It is caused due to a wide variety of reasons which include inherited diseases like thalassemia, sickle cell disease etc, infections, autoimmune conditions, bone marrow dysfunction, blood transfusions and certain drugs can also result in hemolytic anemia .
• Most common presenting symptoms are fatigue, palpitations, dyspnea, tachycardia and icterus in severe cases.
• Diagnosis usually requires a battery of tests including, but not limited to a peripheral smear, CBC, serum LDH, bone marrow studies, etc.
• Treatment is directed by the specific cause and can involve bone marrow transplant, splenectomy, transfusions etc.

Causes

Life threatening causes

• ABO incompatibility
• Disseminated intravascular coagulation
• Thrombotic thrombocytopenic purpura
• Hemolytic uremic syndrome
• Pre-eclampsia and malignant hypertension

Other causes

• Membrane cytoskeletal defects like hereditary spherocytosis and hereditary elliptocytosis
• Glucose 6 phosphate dehydrogenase deficiency
• Pyruvate kinase deficiency
• Sickle cell disease
• Thalassemia
• Cold agglutinin disease
• Drug induced hemolytic anemia
• Systemic lupus erythematosus
• Prosthetic heart valves
• Infectious causes such as malaria, hepatitis, CMV infection etc.

For a complete list of hemolytic anemia causes click here

FIRE

Diagnosis

Below is an algorithm summarising the diagnosis of hemolytic anemia

Treatment

Do's

Don'ts

References