Hemolytic anemia: Difference between revisions

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In [[hematology]], '''{{PAGENAME}}''' is an "A condition of inadequate circulating red blood cells ([[anemia]]) or insufficient hemoglobin due to premature destruction of red blood cells ([[erythrocyte]]s)."<ref>{{MeSH}}</ref>
In [[hematology]], '''{{PAGENAME}}''' is an "A condition of inadequate circulating red blood cells ([[anemia]]) or insufficient hemoglobin due to premature destruction of red blood cells ([[erythrocyte]]s)."<ref>{{MeSH}}</ref>


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Hemolytic anemia associated with ''normal'' red cells
Hemolytic anemia associated with ''normal'' red cells
* Autoimmune hemolytic anemia
* [[Autoimmune hemolytic anemia]]
** Direct antiglobulin ("Coombs") test-negative
** Direct antiglobulin ("Coombs") test-positive
** Cold agglutinin disease<ref name="pmid22330255">{{cite journal| author=Berentsen S, Tjønnfjord GE| title=Diagnosis and treatment of cold agglutinin mediated autoimmune hemolytic anemia. | journal=Blood Rev | year= 2012 | volume= 26 | issue= 3 | pages= 107-15 | pmid=22330255 | doi=10.1016/j.blre.2012.01.002 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22330255  }} </ref>
* Complement-induced lysis
* Complement-induced lysis
* Microangiopathic hemolytic anemia
* [[Microangiopathic hemolytic anemia]]. Includes [[Thrombotic thrombocytopenic purpura]].
* Others


Hemolytic anemia associated with ''abnormal'' red cells
Hemolytic anemia associated with ''abnormal'' red cells
* Hemoglobinopathies
* Hemoglobinopathies. Includes [[Sickle cell anemia]].
* Metabolic deficiency
* Metabolic deficiency
* Erythrocyte membrane abnormality
* Erythrocyte membrane abnormality. Includes [[Hereditary spherocytosis]].
* Others


==Diagnosis==
==Diagnosis==


Hemolysis
* [[Haptoglobin]]'s role in diagnosis has been reviewed.<ref name="pmid24809098">{{cite journal| author=Shih AW, McFarlane A, Verhovsek M| title=Haptoglobin testing in hemolysis: measurement and interpretation. | journal=Am J Hematol | year= 2014 | volume= 89 | issue= 4 | pages= 443-7 | pmid=24809098 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24809098  }} </ref><ref name="pmid7431603">{{cite journal| author=Rice L| title=Serum haptoglobin in hemolytic disease. | journal=JAMA | year= 1980 | volume= 244 | issue= 23 | pages= 2607-8 | pmid=7431603 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7431603  }} </ref> Its accuracy is:<ref name="pmid7365971">{{cite journal| author=Marchand A, Galen RS, Van Lente F| title=The predictive value of serum haptoglobin in hemolytic disease. | journal=JAMA | year= 1980 | volume= 243 | issue= 19 | pages= 1909-11 | pmid=7365971 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7365971  }} </ref>
** [[Sensitivity and specificity|Sensitivity]] 83%
** [[Sensitivity and specificity|Specificity]] 96%
* [[Lactate dehydrogenase]]
* Bilirubin may not be very sensitive.<ref>Pirofsky B. Autoimmunization and the autoimmune hemolytic anemias. Baltimore; Williams & Wilkins: 1969:44-72</ref>
* [[Reticulocyte count]]<ref name="pmid3814817">{{cite journal| author=Liesveld JL, Rowe JM, Lichtman MA| title=Variability of the erythropoietic response in autoimmune hemolytic anemia: analysis of 109 cases. | journal=Blood | year= 1987 | volume= 69 | issue= 3 | pages= 820-6 | pmid=3814817 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3814817  }} </ref>
* Peripheral smear<ref name="pmid16079373">{{cite journal| author=Bain BJ| title=Diagnosis from the blood smear. | journal=N Engl J Med | year= 2005 | volume= 353 | issue= 5 | pages= 498-507 | pmid=16079373 | doi=10.1056/NEJMra043442 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16079373  }} </ref>
Autoimmunity:
* Red-blood-cell-bound [[immunoglobulin]] G<ref name="pmid19105232">{{cite journal| author=Kamesaki T, Oyamada T, Omine M, Ozawa K, Kajii E| title=Cut-off value of red-blood-cell-bound IgG for the diagnosis of Coombs-negative autoimmune hemolytic anemia. | journal=Am J Hematol | year= 2009 | volume= 84 | issue= 2 | pages= 98-101 | pmid=19105232 | doi=10.1002/ajh.21336 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19105232  }} </ref>
* [[Coombs' test]], using the direct method, may have 97% sensitivity for detecting warm antibodies.<ref name="pmid4567200">{{cite journal| author=Worlledge SM, Blajchman MA| title=The autoimmune haemolytic anaemias. | journal=Br J Haematol | year= 1972 | volume= 23 | issue=  | pages= Suppl:61-9 | pmid=4567200 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4567200  }} </ref><ref name="pmid6034957">{{cite journal| author=Allgood JW, Chaplin H| title=Idiopathic acquired autoimmune hemolytic anemia. A review of forty-seven cases treated from 1955 through 1965. | journal=Am J Med | year= 1967 | volume= 43 | issue= 2 | pages= 254-73 | pmid=6034957 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6034957  }} </ref>
Microangiopathic hemolytic anemia
* [[Platelet count]]
* ADAMTS13 protein activity and inhibitor (von Willebrand factor-degrading protease)<ref name="pmid20032506">{{cite journal| author=Kremer Hovinga JA, Vesely SK, Terrell DR, Lämmle B, George JN| title=Survival and relapse in patients with thrombotic thrombocytopenic purpura. | journal=Blood | year= 2010 | volume= 115 | issue= 8 | pages= 1500-11; quiz 1662 | pmid=20032506 | doi=10.1182/blood-2009-09-243790 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20032506  }} </ref>


==References==
==References==
<references/>
<references/>

Latest revision as of 11:51, 8 September 2020

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In hematology, Hemolytic anemia is an "A condition of inadequate circulating red blood cells (anemia) or insufficient hemoglobin due to premature destruction of red blood cells (erythrocytes)."[1]

Classification

One classification is based on whether hemolysis occurs intravascularly or extravascularly. Another classification is whether the erythrocytes are intrinsically normal:[2]

Hemolytic anemia associated with normal red cells

Hemolytic anemia associated with abnormal red cells

Diagnosis

Hemolysis

Autoimmunity:

Microangiopathic hemolytic anemia

  • Platelet count
  • ADAMTS13 protein activity and inhibitor (von Willebrand factor-degrading protease)[13]

References

  1. ↑ Anonymous (2024), Hemolytic anemia (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ Wright DE, Rosovsky RP, Platt MY (2013). "Case records of the Massachusetts General Hospital. Case 36-2013. A 38-year-old woman with anemia and thrombocytopenia.". N Engl J Med 369 (21): 2032-43. DOI:10.1056/NEJMcpc1215972. PMID 24256382. Research Blogging.
  3. ↑ Berentsen S, Tjønnfjord GE (2012). "Diagnosis and treatment of cold agglutinin mediated autoimmune hemolytic anemia.". Blood Rev 26 (3): 107-15. DOI:10.1016/j.blre.2012.01.002. PMID 22330255. Research Blogging.
  4. ↑ Shih AW, McFarlane A, Verhovsek M (2014). "Haptoglobin testing in hemolysis: measurement and interpretation.". Am J Hematol 89 (4): 443-7. PMID 24809098. [e]
  5. ↑ Rice L (1980). "Serum haptoglobin in hemolytic disease.". JAMA 244 (23): 2607-8. PMID 7431603. [e]
  6. ↑ Marchand A, Galen RS, Van Lente F (1980). "The predictive value of serum haptoglobin in hemolytic disease.". JAMA 243 (19): 1909-11. PMID 7365971. [e]
  7. ↑ Pirofsky B. Autoimmunization and the autoimmune hemolytic anemias. Baltimore; Williams & Wilkins: 1969:44-72
  8. ↑ Liesveld JL, Rowe JM, Lichtman MA (1987). "Variability of the erythropoietic response in autoimmune hemolytic anemia: analysis of 109 cases.". Blood 69 (3): 820-6. PMID 3814817. [e]
  9. ↑ Bain BJ (2005). "Diagnosis from the blood smear.". N Engl J Med 353 (5): 498-507. DOI:10.1056/NEJMra043442. PMID 16079373. Research Blogging.
  10. ↑ Kamesaki T, Oyamada T, Omine M, Ozawa K, Kajii E (2009). "Cut-off value of red-blood-cell-bound IgG for the diagnosis of Coombs-negative autoimmune hemolytic anemia.". Am J Hematol 84 (2): 98-101. DOI:10.1002/ajh.21336. PMID 19105232. Research Blogging.
  11. ↑ Worlledge SM, Blajchman MA (1972). "The autoimmune haemolytic anaemias.". Br J Haematol 23: Suppl:61-9. PMID 4567200. [e]
  12. ↑ Allgood JW, Chaplin H (1967). "Idiopathic acquired autoimmune hemolytic anemia. A review of forty-seven cases treated from 1955 through 1965.". Am J Med 43 (2): 254-73. PMID 6034957. [e]
  13. ↑ Kremer Hovinga JA, Vesely SK, Terrell DR, Lämmle B, George JN (2010). "Survival and relapse in patients with thrombotic thrombocytopenic purpura.". Blood 115 (8): 1500-11; quiz 1662. DOI:10.1182/blood-2009-09-243790. PMID 20032506. Research Blogging.
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