Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
• Mechanical Trauma (Microangiopathic hemolytic anemia):
- Disseminated intravascular coagulation (DIC)
- HELLP syndrome
- Thrombotic microangiopathy: Thrombotic thrombocytopenic purpura (TTP), Hemolytic uremic syndrome (HUS)
• Other: Transfusion reaction, Paroxysmal nocturnal hemoglobinuria (PNH)
Extravascular Hemolysis:
• Immune-mediated:
- Autoimmune (AIHA) "Warm" (usually IgG) (e.g. lupus, CLL, lymphoma, idiopathic)
- Autoimmune (AIHA)"Cold" (usually IgM) (e.g. primary cold agglutin disease, lymphoproliferative disorders, Mycoplasma pneumoniae infection)
- Drugs (Beta lactam antibiotics are the most frequently implicated)
- Transfusion reaction
• Intrinsic RBC Defects: Enzyme deficiencies (e.g. G6PD deficiency), Hemoglobinopathies (e.g. sickle cell disease, thalassemias), Membrane defects (e.g. hereditary spherocytosis)
• Infections: Malaria, Babesiosis
• Other: Hypersplenism, Wilson's disease, Copper and lead poisoning
- Dr. Eric Strong @DrEricStrong - Strong Medicine https://www.youtube.com/c/EricsMedi
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