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diagnosis hematology differential hemolytic management product reactions algorithm cold extravascular hemolysis infectiousdiseases intravascular transfusion transfusions travel workup
Cold Agglutinin Disease 3 Types of Cold Sensitive Antibodies: 1. Cold Agglutinins (CAD) 2. Donath-Landsteiner
Positive Coombs testing ... Immunoglobulin M (IgM) • Blood ... sensitize red blood ... Symptoms: High fevers ... #anemia #hematology
Hemolytic Anemia - Differential Diagnosis Algorithm • Sickle cells - Consider sickle cell disease (diverse genotypes):
Hemolytic Anemia ... Agglutination - Cold agglutinins ... suspected, consider malaria ... bartonella (oroya fever ... #testing
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes Intravascular Hemolysis: • Mechanical Trauma (Microangiopathic hemolytic anemia):
Extravascular Causes ... usually IgG) (e.g. lupus ... . primary cold agglutin ... • Infections: Malaria ... #anemia
Fever After International Travel Infectious Disease: • Endemic in either the destination or home region Viral Syndromes: Arboviral infections, a
No hemolytic anemia ... Babesiosis • Plasmodium ... renal function • Blood ... a chest film; blood-smear ... and possibly PCR testing
Blood Product Transfusions One Pager Summary Type and screen - determines blood type and detects in recipient
Crossmatch - involves testing ... S/sx: Fever, flank ... Causes purpura & ... false negatives on testing ... tested include: Malaria
Blood Transfusion Reactions Immune Mediated: • Febrile Non-Hemolytic Transfusion Reaction (FNHTR): Most common immune reaction to transfusion.
S/sx: Fever, flank ... Causes purpura & ... Sx include: fever ... false negatives on testing ... tested include: Malaria
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