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Hemolytic Anemias - Differential Diagnosis Algorithm

Signs of anemia and hemolysis:
 • ↓ Haptoglobin
 • ↑ LDH
- Differential Diagnosis ... Hemolysis: • Autoimmune ... (AIHAs) • Alloimmune ... #Differential #Diagnosis ... #Algorithm #hematology
Autoimmune Hemolytic Anemia (AIHA) - Differential Diagnosis Table

Warm AIHA (48-70%)
Cold AHA (16-32%)
 • Donath-Landsteiner HA (paroxysmal
Autoimmune Hemolytic ... Anemia (AIHA) - ... Differential Diagnosis ... Cold Agglutinin Disease ... #Table #hematology
Red Blood Cell (RBC) Morphology
Microcytic RBC: Pyridoxine deficiency, Thalassemia, Iron deficiency anemia, Chronic disease anemia (sometimes),
Iron deficiency anemia ... spherocytosis, Autoimmune ... Agglutinate: Cold autoimmune ... #differential #diagnosis ... #hematology #microscopy
Anemia - Hemolysis Diagnostic Algorithm
Autoimmune hemolytic anemia
Microangiopathic hemolytic anemia
Probable thalassemia

Dr. Eric Strong @DrEricStrong - Strong Medicine
Anemia - Hemolysis ... Diagnostic Algorithm ... Autoimmune hemolytic ... #Algorithm #hematology ... #diagnosis #differential
Warm Antibody Autoimmune Hemolytic Anemia 
1) DIAGNOSE AIHA
 • Anemia: macrocytic > normocytic, ↑ reticulocytes
 •
Warm Antibody Autoimmune ... 1) DIAGNOSE AIHA ... Warm #Antibody #Autoimmune ... #diagnosis #management ... #treatment #rheumatology
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
Peripheral Blood Smear Analysis
Hypochromia
Megaloblastic Anemia
Schistocytes: Microangiopathic hemolytic anemia (e.g. DIC, TTP, HUS)
Microspherocytes: Autoimmune hemolytic anemia
Sickled red
Megaloblastic Anemia ... Microspherocytes: Autoimmune ... hemolytic anemia ... cells: Sickle cell disease ... Smear #Analysis #hematology
Autoimmune Hemolytic Anemia (AIHA) Pathophysiology - Warm vs Cold AIHA
Warm AIHA:
 - 70%; IgG mediated
 -
Autoimmune Hemolytic ... Anemia (AIHA) Pathophysiology ... #Hemolytic #Anemia ... Pathophysiology #diagnosis ... #hematology
Algorithmic Approach to Anemia - Differential Diagnosis Framework by MCV

Microcytic (MCV < 80) "TAILS":
 • Thalassemia
- Differential Diagnosis ... - Extrinsic: Autoimmune ... Non-megaloblastic: Liver disease ... #Differential #Diagnosis ... #hematology
Expected DAT Results in Autoimmune Hemolysis
DAT Negative Hemolysis
 • DAT Poly ( - ), IgG (
DAT Results in Autoimmune ... Cold agglutinin disease ... #antiglobulin #test ... #Hemolysis #hematology ... #diagnosis