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Hemolytic Anemia - Hemolysis Diagnostic Workup

Infographic by: Howard Ong

#Hemolysis #Hemolytic #Anemia #Algorithm #MAHA #TTP #Diagnosis #Workup
Hemolytic Anemia ... - Hemolysis Diagnostic ... #Hemolytic #Anemia ... Algorithm #MAHA #TTP ... #Hematology
Differential diagnosis of schistocytes / fragmentation hemolysis:
 • Thrombotic microangiopathies (TMA)
    - TTP
fragmentation hemolysis ... crisis • Severe B12 ... anemia" • HELLP ... differential #diagnosis #hematology ... #hemolysis
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Framework for Hemolysis ... Intravascular Hemolysis ... thrombocytopenic purpura (TTP ... ), Hemolytic uremic ... differential #diagnosis #hematology
Hemolytic Anemia - Differential Diagnosis Algorithm
 • Sickle cells - Consider sickle cell disease (diverse genotypes):
Hemolytic Anemia ... thrombocytopenia - DIC, TTP ... elliptocytosis, autoimmune hemolysis ... ARUPConsult @ARUPLabs #Hemolytic ... #hematology #testing
Peripheral Blood Smear Analysis
Hypochromia
Megaloblastic Anemia
Schistocytes: Microangiopathic hemolytic anemia (e.g. DIC, TTP, HUS)
Microspherocytes: Autoimmune hemolytic anemia
Sickled red
Microangiopathic hemolytic ... DIC, TTP, HUS) ... Microspherocytes: Autoimmune hemolytic ... 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 ... > 10, no more hemolysis ... AIHA #Autoimmune #Hemolytic ... #hematology
Red Blood Cell (RBC) Morphology
Microcytic RBC: Pyridoxine deficiency, Thalassemia, Iron deficiency anemia, Chronic disease anemia (sometimes),
, Chronic disease ... Microangiopathic Hemolytic ... spherocytosis, Autoimmune hemolytic ... Cold autoimmune hemolytic ... 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 ... #Autoimmune #Hemolytic ... #hematology
Causes of Anemia by Mean Corpuscular Volume (MCV) - Differential Diagnosis Algorithm
Low Mean Corpuscular Volume (<80
of Chronic Disease ... • Bleeding • Hemolysis ... of Chronic Disease ... (>100 fL) • B12 ... Algorithm #Causes #Hematology
Reticulocyte Production Index = (Retic %) x (Hct / 45) / Maturation Factor
The maturation factor is
loss), Vitamin B12 ... kidney disease, ... Retroperitoneal, Uterine • Hemolysis ... Microangiopathic hemolytic ... Production #Index #hematology