12 results
Cold Agglutinin Disease

3 Types of Cold Sensitive Antibodies:
  1. Cold Agglutinins (CAD)
  2. Donath-Landsteiner
Diagnosis: • hemolytic ... • Compensated hemolysis ... IgM) • Blood smear ... younger pts) Differential ... #disease #hemolytic
Hemolytic Anemias - Differential Diagnosis Algorithm

Signs of anemia and hemolysis:
 • ↓ Haptoglobin
 • ↑ LDH
Hemolytic Anemias ... - Differential ... of anemia and hemolysis ... Abnormal peripheral smear ... #Anemias #Differential
Autoimmune Hemolytic Anemia (AIHA) - Differential Diagnosis Table

Warm AIHA (48-70%)
Cold AHA (16-32%)
 • Donath-Landsteiner HA (paroxysmal
Autoimmune Hemolytic ... Anemia (AIHA) - Differential ... hemoglobinuria) • Cold Agglutinin ... #Autoimmune #Hemolytic ... #Anemia #AIHA #Differential
Hemolytic Anemia - Differential Diagnosis Algorithm
Hereditary:
 • Peripheral blood smear + DAT + further History
 •
Hemolytic Anemia ... - Differential ... Peripheral blood smear ... Immune mediated hemolysis ... #Anemia #Differential
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Framework for Hemolysis ... Intravascular Hemolysis ... Microangiopathic hemolytic ... . primary cold agglutin ... Extravascular #Causes #differential
Warm Antibody Autoimmune Hemolytic Anemia 
1) DIAGNOSE AIHA
 • Anemia: macrocytic > normocytic, ↑ reticulocytes
 •
Antibody Autoimmune Hemolytic ... reticulocytes • Hemolysis ... C3d • Blood smear ... : Differential → ... Antibody #Autoimmune #Hemolytic
Hemolytic Anemia - Differential Diagnosis Algorithm
 • Sickle cells - Consider sickle cell disease (diverse genotypes):
Hemolytic Anemia ... - Differential ... Agglutination - Cold agglutinins ... ARUPConsult @ARUPLabs #Hemolytic ... #Anemia #Differential
Pancytopenia - Differential Diagnosis Algorithm
 • 12-13 g/dL,
 • ANC < 1800/uL,
 • platelet < 150,000/uL

Initial
Pancytopenia - Differential ... acid, peripheral smear ... studies, PT/aPTT Differential ... ↑ Destruction (hemolysis ... #Pancytopenia #Differential
Hemolysis - Differential Diagnosis Framework

1) Environment
  - Fragmentation
  - MAHA: TTP, HUS, DIC, HELLP
Hemolysis - Differential ... Peripheral Blood Smear ... Urobilinogen #Hemolysis ... #Differential #
TTP - Laboratory Evaluation for Thrombotic Thrombocytopenic Purpura

Activity of von Willebrand factor-cleaving protease activity - A
hemorrhage and hemolysis ... intravascular hemolysis ... Peripheral blood smear ... out an immune hemolytic ... WBC count and differential