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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 ... Anemia #Algorithm #hematology ... #differential #workup
Autoimmune Hemolytic Anemia (AIHA) - Differential Diagnosis Table

Warm AIHA (48-70%)
Cold AHA (16-32%)
 • Donath-Landsteiner HA (paroxysmal
Autoimmune Hemolytic ... Differential Diagnosis Table ... Cold Agglutinin Disease ... #Hemolytic #Anemia ... #hematology
Warm vs Cold Autoimmune Hemolytic Anemia
Warm Autoimmune Hemolytic Anemia:
 • Mechanism: IgG and Complement-mediated
 • Etiology:
Hemolytic Anemia ... Warm Autoimmune ... Spherocytes • Treatment ... • Treatment: Warm ... #hematology #diagnosis
Peripheral Blood Smear Analysis
Hypochromia
Megaloblastic Anemia
Schistocytes: Microangiopathic hemolytic anemia (e.g. DIC, TTP, HUS)
Microspherocytes: Autoimmune hemolytic anemia
Sickled red
Peripheral Blood ... Microspherocytes: Autoimmune ... hemolytic anemia ... cells: Sickle cell disease ... Smear #Analysis #hematology
Autoimmune Hemolytic Anemia (AIHA) Treatment
Warm AIHA:
1) Steroids - 1-2 mg/kg prednisone daily
   • Until
Autoimmune Hemolytic ... Anemia (AIHA) Treatment ... esp if severe disease ... #AIHA #Treatment ... #management #hematology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Immune-mediated: - Autoimmune ... idiopathic) - Autoimmune ... cold agglutin disease ... e.g. sickle cell disease ... differential #diagnosis #hematology
Algorithm for workup of thrombocytopenia based on observation of the peripheral blood film. 
TTP/HUS indicates thrombotic
Algorithm for workup ... the peripheral blood ... thrombocytopenic purpura/hemolytic ... thrombocytopenia, Hematology
Red Blood Cell (RBC) Morphology
Microcytic RBC: Pyridoxine deficiency, Thalassemia, Iron deficiency anemia, Chronic disease anemia (sometimes),
Red Blood Cell ( ... Macrocytic RBC: Vitamin B12 ... , McLeod blood group ... spherocytosis, Autoimmune ... differential #diagnosis #hematology
Pancytopenia - Differential Diagnosis

Congenital Diseases:
• GATA2 deficiency
• Fanconi’s anemia
• Wiskott-Aldrich syndrome
• Ribosomopathy or telomeropathy

Cancer:
• Leukemia
• Lymphoma

Inflammatory
Congenital Diseases ... Inflammatory and Autoimmune ... Antibody-mediated hemolysis ... consumption • Vitamin B12 ... Differential #Diagnosis #Hematology
Hemolytic Anemia - Differential Diagnosis Algorithm
 • Sickle cells - Consider sickle cell disease (diverse genotypes):
Hemolytic Anemia ... Consider sickle cell disease ... elliptocytosis, autoimmune ... Diagnosis #Algorithm #workup ... #hematology #testing