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Hemolytic Anemias - Differential Diagnosis Algorithm

Signs of anemia and hemolysis:
 • ↓ Haptoglobin
 • ↑ LDH
(AIHAs) • Alloimmune ... • Extrinsic RBC ... • Intrinsic RBC ... #Anemias #Differential ... Diagnosis #Algorithm #hematology
Autoimmune Hemolytic Anemia (AIHA) - Differential Diagnosis Table

Warm AIHA (48-70%)
Cold AHA (16-32%)
 • Donath-Landsteiner HA (paroxysmal
Autoimmune Hemolytic ... Anemia (AIHA) - ... #Hemolytic #Anemia ... #AIHA #Differential ... Diagnosis #Table #hematology
Warm Antibody Autoimmune Hemolytic Anemia 
1) DIAGNOSE AIHA
 • Anemia: macrocytic > normocytic, ↑ reticulocytes
 •
Hemolytic Anemia ... 1) DIAGNOSE AIHA ... ↑ LDH • Anti-RBC ... screening 3) TREAT AIHA ... #Hemolytic #Anemia
Causes of Extravascular and Intravascular Hemolysis - Differential Diagnosis Algorithm
Extravascular - Spleen and RES-mediated hemolysis
 -
Immune-Mediated • Warm AIHA ... • Cold AIHA ... • Drug-induced AIHA ... elliptocytosis - RBC ... Algorithm #Causes #Hematology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
(AIHA) "Warm" ( ... (AIHA)"Cold" (usually ... • Intrinsic RBC ... Extravascular #Causes #differential ... #diagnosis #hematology
Autoimmune Hemolytic Anemia (AIHA) Treatment
Warm AIHA:
1) Steroids - 1-2 mg/kg prednisone daily
   • Until
Autoimmune Hemolytic ... Anemia (AIHA) Treatment ... #Autoimmune #Hemolytic ... #Anemia #AIHA # ... #hematology
Hemolysis - Differential Diagnosis Framework

1) Environment
  - Fragmentation
  - MAHA: TTP, HUS, DIC, HELLP
Hemolysis - Differential ... 2) External (RBC ... : Warm AIHA, Cold ... AIHA, Transfusion ... Diagnosis #hematology
Red Blood Cell (RBC) Morphology
Microcytic RBC: Pyridoxine deficiency, Thalassemia, Iron deficiency anemia, Chronic disease anemia (sometimes),
spherocytosis, Autoimmune ... hemolytic anemia ... hemolytic anemia ... #Morphology #differential ... #diagnosis #hematology
Algorithmic Approach to Anemia - Differential Diagnosis Framework by MCV

Microcytic (MCV < 80) "TAILS":
 • Thalassemia
- Differential ... , CKD • Hemolytic ... Spherocytosis, G6PD, PK, HbC ... - Extrinsic: Autoimmune ... #Diagnosis #hematology
Hemolytic Anemia - Differential Diagnosis Algorithm
 • Sickle cells - Consider sickle cell disease (diverse genotypes):
Hemolytic Anemia ... hypertension • Unusual RBC ... acanthocytes - Consider RBC ... #Anemia #Differential ... Algorithm #workup #hematology