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Hemolytic Anemias - Differential Diagnosis Algorithm

Signs of anemia and hemolysis:
 • ↓ Haptoglobin
 • ↑ LDH
Hemolytic Anemias ... : • Autoimmune ... Hemolytic Anemias ... Hemolytic Anemias ... Hypersplenism, Infection
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
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
anemia): ... idiopathic) - Autoimmune ... Mycoplasma pneumoniae infection ... spherocytosis) • Infections ... #anemia
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 ... Polyclonal: - Infection ... #Hemolytic #Anemia
Warm Antibody Autoimmune Hemolytic Anemia 
1) DIAGNOSE AIHA
 • Anemia: macrocytic > normocytic, ↑ reticulocytes
 •
Warm Antibody Autoimmune ... Hemolytic Anemia ... #Hemolytic #Anemia ... diagnosis #management #treatment ... #rheumatology
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 ... #Hemolytic #Anemia ... Diagnosis #Table #hematology
Hemolytic Anemia - Differential Diagnosis Algorithm
Hereditary:
 • Peripheral blood smear + DAT + further History
 •
Hemolytic Anemia ... → Sickle Cell anemia ... idiopathic, malignancy, autoimmune ... disease, drugs, ... Fevers, DAT (-) → Infection
Red Blood Cell (RBC) Morphology
Microcytic RBC: Pyridoxine deficiency, Thalassemia, Iron deficiency anemia, Chronic disease anemia (sometimes),
spherocytosis, Autoimmune ... hemolytic anemia ... Agglutinate: Cold autoimmune ... hemolytic anemia ... differential #diagnosis #hematology
Algorithmic Approach to Anemia - Differential Diagnosis Framework by MCV

Microcytic (MCV < 80) "TAILS":
 • Thalassemia
-100): • Non-hemolytic ... , CKD • Hemolytic ... - Extrinsic: Autoimmune ... Macroangiopathic, Infections ... Non-megaloblastic: Liver disease
Peripheral Blood Smear Analysis
Hypochromia
Megaloblastic Anemia
Schistocytes: Microangiopathic hemolytic anemia (e.g. DIC, TTP, HUS)
Microspherocytes: Autoimmune hemolytic anemia
Sickled red
Microangiopathic hemolytic ... Microspherocytes: Autoimmune ... hemolytic anemia ... cells: Sickle cell disease ... Smear #Analysis #hematology