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Algorithm for the Diagnosis and Workup of Hemolytic Anemia

By Dr. Kylie Adamek @KylieAdamek

#Hemolytic #Anemia #Algorithm #Differential
Diagnosis and Workup ... of Hemolytic Anemia ... #Differential # ... Diagnosis #Workup ... #Hematology #Hemolysis
Anemia - Hemolysis Diagnostic Algorithm
Autoimmune hemolytic anemia
Microangiopathic hemolytic anemia
Probable thalassemia

Dr. Eric Strong @DrEricStrong - Strong Medicine
Anemia - Hemolysis ... hemolytic anemia ... #hematology #diagnosis ... #differential # ... workup
Hemolytic Anemias - Differential Diagnosis Algorithm

Signs of anemia and hemolysis:
 • ↓ Haptoglobin
 • ↑ LDH
Hemolytic Anemias ... - Differential ... Hypersplenism, Infection ... #Anemias #Differential ... Diagnosis #Algorithm #hematology
Hemolysis - Diagnostic Algorithm and Causes

Increased red cell production: 
 • Increased Reticulocytosis/polychromasia 
 • Erythroid
Hemolysis - Diagnostic ... #Hemolytic #Anemia ... #Algorithm #Differential ... #Causes #Workup ... #Hematology #Diagnosis
Hemolytic Anemia - Differential Diagnosis Algorithm
 • Sickle cells - Consider sickle cell disease (diverse genotypes):
Hemolytic Anemia ... inclusions - If infection ... bartonella (oroya fever ... #Anemia #Differential ... #hematology #testing
Causes of Hemolytic Anemia - Differential Diagnosis
Inherited
 • Membrane
 • Internal
    - Hemoglobin
Causes of Hemolytic ... Anemia - Differential ... Internal - Infectious ... #Anemia #Differential ... Diagnosis #Causes #hematology
Hemolytic Anemia - Differential Diagnosis Algorithm
Hereditary:
 • Peripheral blood smear + DAT + further History
 •
Hemolytic Anemia ... - Differential ... Recent travel/Fevers ... , DAT (-) → Infection ... #Anemia #Differential
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
anemia): ... spherocytosis) • Infections ... Extravascular #Causes #differential ... #diagnosis #hematology ... #anemia
Algorithmic Approach to Anemia - Differential Diagnosis Framework by MCV

Microcytic (MCV < 80) "TAILS":
 • Thalassemia
- Differential ... , CKD • Hemolytic ... Macroangiopathic, Infections ... Non-megaloblastic: Liver ... #Diagnosis #hematology
Fever Patterns - Differential Diagnosis Framework

Continuous Fever:
Temp > 38°C with only 1 degree fluctuation in 24
Differential Diagnosis ... and bacterial infections ... schistosomiasis • Pyemia ... with profound hemolysis ... #Patterns #Differential