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diagnosis differential hematology clinical algorithm anemia microscopy causes blood management pathology workup path microbiology bloodsmear pathophysiology classification nephrology hemolysis comparison
Laboratory Testing in Hemolytic Anemia Intravascular vs Extravascular Hemolysis Reticulocytes Unconjugated bilirubin LDH Peripheral smear Haptoglobin Urine hemosiderin Urine hemoglobin Carboxyhemoglobin #Hemolytic #Anemia #Laboratory #Testing #workup
Laboratory Testing in Hemolytic ... Extravascular Hemolysis ... Reticulocytes ... LDH Peripheral smear ... Carboxyhemoglobin #Hemolytic
Hemolytic Anemias - Differential Diagnosis Algorithm Signs of anemia and hemolysis: • ↓ Haptoglobin • ↑ LDH
Hemolytic Anemias ... of anemia and hemolysis ... bilirubin • ↑ Reticulocytes ... Abnormal peripheral smear ... Immune-mediated Hemolysis
Pancytopenia - Differential Diagnosis Algorithm • 12-13 g/dL, • ANC < 1800/uL, • platelet < 150,000/uL Initial
acid, peripheral smear ... , reticulocyte count ... Production (↓ reticulocytes ... ↑ Destruction (hemolysis ... , ↑ reticulocytes
Warm Antibody Autoimmune Hemolytic Anemia 1) DIAGNOSE AIHA • Anemia: macrocytic > normocytic, ↑ reticulocytes •
Antibody Autoimmune Hemolytic ... normocytic, ↑ reticulocytes ... • Hemolysis: ... C3d • Blood smear ... Antibody #Autoimmune #Hemolytic
Algorithm for the evaluation of macrocytic anemia. (RBC = red blood cell; MMA = methylmalonic acid.) Physicians
ordering a peripheral smear ... , a reticulocyte ... specifically order a reticulocyte ... Hemorrhage or hemolysis ... elevation in the reticulocyte
Hemolysis - Differential Diagnosis Framework 1) Environment - Fragmentation - MAHA: TTP, HUS, DIC, HELLP
Hemolysis - Differential ... Peripheral Blood Smear ... abnormal RBCs - Reticulocyte ... Urobilinogen #Hemolysis
Calculating a Reticulocyte Index (RI) Reticulocyte Index = Absolute Reticulocyte Count / Maturation Correction Absolute Reticulocyte Count =
Calculating a Reticulocyte ... Index (RI) Reticulocyte ... Index = Absolute Reticulocyte ... Count = % of reticulocytes ... SatyaPatelMD #Reticulocyte
Approach to Thrombotic Microangiopathy (TMA) - Differential Diagnosis and Management Algorithm Suspected TMA: Unexplained thrombocytopenia + MAHA
labs: CBC, BMP, Reticulocytes ... , smear, Haptoglobin ... MAHA likely: • Smear ... schistocytes > 1% • ↑ Reticulocyte
Anemia Diagnostic Algorithm Mean corpuscular (cell) volume (MCV): Average RBC size. Under 80 = microcytic. Between 80-95
Reticulocyte count ... percentage of reticulocytes ... acute blood loss, hemolysis ... Corrected reticulocyte ... count OR reticulocyte
Hemolytic Anemia - Differential Diagnosis Algorithm Hereditary: • Peripheral blood smear + DAT + further History •
Hemolytic Anemia ... Peripheral blood smear ... Immune mediated hemolysis ... Microangiopathic hemolytic ... UnremarkableLab #Hemolytic
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