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Hemolytic Anemias - Differential Diagnosis Algorithm

Signs of anemia and hemolysis:
 • ↓ Haptoglobin
 • ↑ LDH
Hemolytic Anemias ... Abnormal peripheral smear ... Anemias (AIHAs) ... • Extrinsic RBC ... • Intrinsic RBC
Laboratory Testing in Hemolytic Anemia

Intravascular vs Extravascular Hemolysis
Reticulocytes
Unconjugated bilirubin
LDH
Peripheral smear
Haptoglobin
Urine hemosiderin
Urine hemoglobin
Carboxyhemoglobin

#Hemolytic #Anemia #Laboratory #Testing #workup
Anemia Intravascular ... Extravascular Hemolysis ... LDH Peripheral smear ... #Anemia #Laboratory ... #Testing #workup
Peripheral Blood Smear Analysis
Hypochromia
Megaloblastic Anemia
Schistocytes: Microangiopathic hemolytic anemia (e.g. DIC, TTP, HUS)
Microspherocytes: Autoimmune hemolytic anemia
Sickled red
Peripheral Blood ... Smear Analysis ... #Smear #Analysis ... #hematology #microscopy ... interpretation #clinical
Warm Antibody Autoimmune Hemolytic Anemia 
1) DIAGNOSE AIHA
 • Anemia: macrocytic > normocytic, ↑ reticulocytes
 •
Anemia 1) DIAGNOSE ... AIHA • Anemia ... ↑ LDH • Anti-RBC ... type ± C3d • Blood ... smear: Differential
Peripheral blood findings in microangiopathic hemolytic anemia.  DIC is a clinical and laboratory diagnosis, not
Peripheral blood ... DIC is a clinical ... arrow) Peripheral smear ... #Pathology #Smear ... #Microscopy
Hemolytic Anemia - Differential Diagnosis Algorithm
Hereditary:
 • Peripheral blood smear + DAT + further History
 •
Hemolytic Anemia ... • Peripheral blood ... smear + DAT + further ... → Sickle Cell anemia ... anemia (TTP, HUS
Red Blood Cell (RBC) Morphology
Microcytic RBC: Pyridoxine deficiency, Thalassemia, Iron deficiency anemia, Chronic disease anemia (sometimes),
Red Blood Cell ( ... disease, McLeod blood ... Microangiopathic Hemolytic ... Cold autoimmune hemolytic ... diagnosis #hematology #microscopy
Babesia spp. on Peripheral Blood Smear Microscopy
 - Multiple small parasites per RBC
 - "maltese cross"
on Peripheral Blood ... Smear Microscopy ... parasites per RBC ... richdavisphd #Babesia #clinical ... #smear
Dacrocytes (tear drop cells) 
Other poikilocytes resemble a pear or teardrop. The narrow, tapered end
may be
thalassemia, and some hemolytic ... anemias. ... #Clinical #Path ... #BloodSmear #Blood ... #Smear #Dacrocytes
Spur-Cell Anemia- A 31-year-old man with a history of cirrhosis, recurrent hepatic encephalopathy, and anemia presented
smear showed numerous ... , a form of hemolytic ... inflexible and prone to hemolysis ... #NEJM #clinical ... #smear