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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
Warm vs Cold Autoimmune Hemolytic Anemia
Warm Autoimmune Hemolytic Anemia:
 • Mechanism: IgG and Complement-mediated
 • Etiology:
Hemolytic Anemia ... Warm Autoimmune Hemolytic ... Autoimmune Hemolytic ... #Autoimmune #Hemolytic ... #Anemia #hematology
Autoimmune Hemolytic Anemia (AIHA) - Differential Diagnosis Table

Warm AIHA (48-70%)
Cold AHA (16-32%)
 • Donath-Landsteiner HA (paroxysmal
Autoimmune Hemolytic ... Anemia (AIHA) - ... Agglutinin Disease ... #Autoimmune #Hemolytic ... #hematology
Causes of Extravascular and Intravascular Hemolysis - Differential Diagnosis Algorithm
Extravascular - Spleen and RES-mediated hemolysis
 -
Intravascular Hemolysis ... and RES-mediated hemolysis ... Intravascular - Hemolysis ... immune-complex hemolytic ... Algorithm #Causes #Hematology
Hemolytic Anemia - Differential Diagnosis Algorithm
 • Sickle cells - Consider sickle cell disease (diverse genotypes):
Hemolytic Anemia ... Agglutination - Cold ... elliptocytosis, autoimmune hemolysis ... ARUPConsult @ARUPLabs #Hemolytic ... #hematology #testing
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
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
Red Blood Cell (RBC) Morphology
Microcytic RBC: Pyridoxine deficiency, Thalassemia, Iron deficiency anemia, Chronic disease anemia (sometimes),
Macrocytic RBC: Vitamin B12 ... Microangiopathic Hemolytic ... spherocytosis, Autoimmune hemolytic ... autoimmune hemolytic ... differential #diagnosis #hematology