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Hemolytic Anemias - Differential Diagnosis Algorithm

Signs of anemia and hemolysis:
 • ↓ Haptoglobin
 • ↑ LDH
Hemolytic Anemias ... : • Autoimmune ... Hemolytic Anemias ... Hemolytic Anemias ... Diagnosis #Algorithm #hematology
Anemia - Hemolysis Diagnostic Algorithm
Autoimmune hemolytic anemia
Microangiopathic hemolytic anemia
Probable thalassemia

Dr. Eric Strong @DrEricStrong - Strong Medicine
Anemia - Hemolysis ... Diagnostic Algorithm Autoimmune ... hemolytic anemia ... #hematology #diagnosis ... #differential #workup
Red Blood Cell (RBC) Morphology
Microcytic RBC: Pyridoxine deficiency, Thalassemia, Iron deficiency anemia, Chronic disease anemia (sometimes),
: Vitamin B12 or ... spherocytosis, Autoimmune ... hemolytic anemia ... hemolytic anemia ... differential #diagnosis #hematology
Warm vs Cold Autoimmune Hemolytic Anemia
Warm Autoimmune Hemolytic Anemia:
 • Mechanism: IgG and Complement-mediated
 • Etiology:
Hemolytic Anemia ... Hemolytic Anemia ... Hemolytic Anemia ... #Hemolytic #Anemia ... #hematology #diagnosis
Hemolytic Anemia - Differential Diagnosis Algorithm
 • Sickle cells - Consider sickle cell disease (diverse genotypes):
Hemolytic Anemia ... elliptocytosis, autoimmune ... #Anemia #Differential ... Diagnosis #Algorithm #workup ... #hematology #testing
Warm Antibody Autoimmune Hemolytic Anemia 
1) DIAGNOSE AIHA
 • Anemia: macrocytic > normocytic, ↑ reticulocytes
 •
Hemolytic Anemia ... ↑ LDH • Anti-RBC ... #Hemolytic #Anemia ... diagnosis #management #treatment ... #rheumatology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
anemia): ... idiopathic) - Autoimmune ... • Intrinsic RBC ... differential #diagnosis #hematology ... #anemia
Algorithmic Approach to Anemia - Differential Diagnosis Framework by MCV

Microcytic (MCV < 80) "TAILS":
 • Thalassemia
, CKD • Hemolytic ... - Extrinsic: Autoimmune ... Folate deficiency, B12 ... Non-megaloblastic: Liver disease ... Differential #Diagnosis #hematology
Autoimmune Hemolytic Anemia (AIHA) - Differential Diagnosis Table

Warm AIHA (48-70%)
Cold AHA (16-32%)
 • Donath-Landsteiner HA (paroxysmal
Autoimmune Hemolytic ... Anemia (AIHA) - ... Cold Agglutinin Disease ... #Hemolytic #Anemia ... Diagnosis #Table #hematology
Common RBC Inclusions and Associations
 • Howell Jolly Bodies: Hyposplenism, Asplenism, Severe hemolytic anemia
 • Heinz
Common RBC Inclusions ... Asplenism, Severe hemolytic ... , Hemolytic anemia ... : Hemoglobin H disease ... Bodies #diagnosis #hematology