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Warm Antibody Autoimmune Hemolytic Anemia 1) DIAGNOSE AIHA • Anemia: macrocytic > normocytic, ↑ reticulocytes •
↑ LDH • Anti-RBC ... 2) LOOK FOR a cause ... Rituximab +++ 3 - Splenectomy
Urine Microscopy and Casts - Image Atlas Key - Squamous Epithelial Casts - Transitional Epithelial Cells - Renal Tubular
Microscopy and Casts ... - Monomorphic RBCs ... - Dysmorphic RBCs ... - WBC Cast - ... RBC Cast - Fatty
Red Blood Cell (RBC) Morphology Microcytic RBC: Pyridoxine deficiency, Thalassemia, Iron deficiency anemia, Chronic disease anemia (sometimes),
Red Blood Cell (RBC ... Morphology Microcytic RBC ... phenotype, Post-splenectomy ... Bite Cell RBC: G6PD ... Hemoglobinopathies, Post-splenectomy
Overall Approach to Anemia - Differential Diagnosis Algorithm Blood Loss • Acute Bleed - Normocytic / Normochromic
/ Normochromic RBCs ... TIBC, Hypochromic RBCs ... Decreased RBC ... Disorder • RBC ... Diagnosis #Algorithm #Causes
Common RBC Inclusions and Associations • Howell Jolly Bodies: Hyposplenism, Asplenism, Severe hemolytic anemia • Heinz
Common RBC Inclusions ... Hemolytic anemia, Post-splenectomy ... Sickle cell, MDS #RBC
Causes of Thrombocytosis - Differential Diagnosis Algorithm Spurious: • Artifact (redo CBC) Autonomous: • Essential thrombocytosis • Polycythemia
Causes of Thrombocytosis ... Artifact (redo CBC ... Other: • Post-splenectomy ... Diagnosis #Algorithm #Causes
Causes of Anemia with Normal Mean Corpuscular Volume (MCV) - Differential Diagnosis Algorithm Decreased WBCs - Decreased/NormaI
Causes of Anemia ... Macrocytes, Normal RBCs ... Spherocytes, RBC ... ) - Abnormal RBCs ... Diagnosis #Algorithm #Causes
Nephritic vs Nephrotic Syndrome Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes. Step
glomerular hematuria (RBC ... casts or dysmorphic ... RBCs in urine)?
Hematuria Workup and Diagnosis Algorithm • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
Urinalysis >3 RBCs ... (proteinuria, RBC ... casts, dysmorphic ... RBCs)? ... Nephrology if cause
Causes of Proteinuria - Differential Diagnosis Algorithm Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
Causes of Proteinuria ... urine sediment - WBC ... /RBC casts ... Diagnosis #Algorithm #Causes
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