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diagnosis differential causes hematology algorithm anemia nephrology management classification rheumatology workup nutrition signs symptoms iron sle erythematosus systemic testing dermatology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes Intravascular Hemolysis: • Mechanical Trauma (Microangiopathic hemolytic anemia):
anemia): ... usually IgG) (e.g. lupus ... cold agglutin disease ... G6PD deficiency) ... diagnosis #hematology #anemia
Hemolytic Anemia - Differential Diagnosis Algorithm Hereditary: • Peripheral blood smear + DAT + further History •
Hemolytic Anemia ... DAT (-) → G6PD Deficiency ... → Sickle Cell anemia ... malignancy, autoimmune disease ... anemia (TTP, HUS
Red Blood Cell (RBC) Morphology Microcytic RBC: Pyridoxine deficiency, Thalassemia, Iron deficiency anemia, Chronic disease anemia (sometimes),
RBC: Pyridoxine deficiency ... disease anemia ... Microangiopathic Hemolytic ... spherocytosis, Autoimmune hemolytic ... Cold autoimmune hemolytic
Hemolytic Anemia - Differential Diagnosis Algorithm • Sickle cells - Consider sickle cell disease (diverse genotypes):
Hemolytic Anemia ... Consider sickle cell disease ... , Hemoglobin H disease ... ARUPConsult @ARUPLabs #Hemolytic ... #Anemia #Differential
Red Blood Cell (RBC) Morphology Atlas • Microcytic - Iron-deficiency anemia, Thalassemia, Sideroblastic anemia, Lead poisoning
Microcytic - Iron-deficiency ... , Liver diseases ... spherocytosis, Hemolytic ... , Liver diseases ... Schistocytes - Hemolytic
Differential diagnosis of schistocytes / fragmentation hemolysis: • Thrombotic microangiopathies (TMA) - TTP
fragmentation hemolysis ... toxin-mediated hemolytic-uremic ... • Severe B12 deficiency ... • Mechanical hemolysis ... anemia" • HELLP
Pancytopenia - Differential Diagnosis Congenital Diseases: • GATA2 deficiency • Fanconi’s anemia • Wiskott-Aldrich syndrome • Ribosomopathy or telomeropathy Cancer: • Leukemia • Lymphoma Inflammatory
Congenital Diseases ... : • GATA2 deficiency ... • Fanconi’s anemia ... : • Systemic lupus ... Antibody-mediated hemolysis
Algorithmic Approach to Anemia - Differential Diagnosis Framework by MCV Microcytic (MCV < 80) "TAILS": • Thalassemia
inflammation) • Iron deficiency ... -100): • Non-hemolytic ... , CKD • Hemolytic ... , B12 deficiency ... Non-megaloblastic: Liver disease
Peripheral Blood Smear Analysis Hypochromia Megaloblastic Anemia Schistocytes: Microangiopathic hemolytic anemia (e.g. DIC, TTP, HUS) Microspherocytes: Autoimmune hemolytic anemia Sickled red
Microangiopathic hemolytic ... anemia (e.g. ... Microspherocytes: Autoimmune hemolytic ... cells: Sickle cell disease ... Bite cells: G6PD deficiency
Causes of Anemia by Mean Corpuscular Volume (MCV) - Differential Diagnosis Algorithm Low Mean Corpuscular Volume (<80
Causes of Anemia ... 80 fL) • Iron Deficiency ... • Bleeding • Hemolysis ... 100 fL) • B12 Deficiency ... • Folate Deficiency
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