Hemolytic anemia classification: Difference between revisions
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==Overview== | ==Overview== | ||
Hemolytic anemia can be divided into intravascular and extravascular based on whether the destruction of RBC occurs in the vessels or outside the vessels, usually in spleen and liver. Extravascular hemolytic anemia is more common than intravascular hemolytic anemia. There are many types of [[hemolytic anemia]]s and the general classification of hemolytic anemia is either acquired or inherited. | Hemolytic anemia can be divided into intravascular and extravascular based on whether the destruction of RBC occurs in the vessels or outside the vessels, usually in spleen and liver. Extravascular hemolytic anemia is more common than intravascular hemolytic anemia. There are many types of [[hemolytic anemia]]s and the general classification of hemolytic anemia is either acquired or inherited (genetic). Genetic conditions include [[red blood cell]] membrane or enzyme defects that predispose the [[red blood cells]] to hemolysis. | ||
==Classification== | ==Classification== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Shyam Patel [2]
Overview
Hemolytic anemia can be divided into intravascular and extravascular based on whether the destruction of RBC occurs in the vessels or outside the vessels, usually in spleen and liver. Extravascular hemolytic anemia is more common than intravascular hemolytic anemia. There are many types of hemolytic anemias and the general classification of hemolytic anemia is either acquired or inherited (genetic). Genetic conditions include red blood cell membrane or enzyme defects that predispose the red blood cells to hemolysis.
Classification
Location of Hemolysis
- Intravascular: This refers to red blood cell destruction within the blood vessels.
- Extravascular: This refers to red blood cell destruction outside the blood vessels, such as in the liver or spleen.
Types of Hemolytic Anemias
- Secondary immune hemolytic anemia[1]
- Idiopathic autoimmune hemolytic anemia
- Non-immune hemolytic anemia caused by chemicals or toxins
- Microangiopathic hemolytic anemia (MAHA)
- Sickle-cell anemia
- Hemoglobin SC disease (similar in symptoms to sickle-cell anemia)
- Thalassemia
- Hemolytic anemia due to G6PD deficiency
- Paroxysmal nocturnal hemoglobinuria (PNH)
- Hereditary elliptocytosis
- Hereditary ovalocytosis
- Hereditary spherocytosis
- Malaria
- Transfusion of blood from a donor with a different blood type
Hemolytic anemias can be either genetic or acquired.
Genetic
- Genetic conditions of RBC membrane
- Genetic conditions of RBC metabolism (enzyme defects)
- Glucose-6-phosphate dehydrogenase deficiency (G6PD or favism)
- Pyruvate kinase deficiency
- Genetic conditions of hemoglobin
Acquired
Acquired hemolytic anemia can be further divided into immune and non-immune mediated.
Immune mediated hemolytic anaemia (direct Coombs test is positive)
- Autoimmune hemolytic anemia
- Warm antibody autoimmune hemolytic anemia
- Idiopathic
- Systemic lupus erythematosus (SLE)
- Evans' syndrome (antiplatelet antibodies and haemolytic antibodies)
- Cold antibody autoimmune hemolytic anemia
- Idiopathic cold hemagglutinin syndrome
- Infectious mononucleosis and mycoplasma (atypical) pneumonia
- Paroxysmal cold hemoglobinuria (rare)
- Warm antibody autoimmune hemolytic anemia
- Alloimmune hemolytic anemia
- Haemolytic disease of the newborn (HDN)
- Rh disease (Rh D)
- ABO hemolytic disease of the newborn
- Anti-Kell hemolytic disease of the newborn
- Rhesus c hemolytic disease of the newborn
- Rhesus E hemolytic disease of the newborn
- Other blood group incompatibility (RhC, Rhe, Kidd, Duffy, MN, P and others)
- Alloimmune hemolytic blood transfusion reactions (ie from a non-compatible blood type)
- Haemolytic disease of the newborn (HDN)
- Drug induced immune mediated hemolytic anemia
- Penicillin (high dose)
- Methyldopa
Non-immune mediated hemolytic anemia (direct Coombs test is negative)
- Drugs (i.e., some drugs and other ingested substances lead to hemolysis by direct action on RBCs)
- Toxins (e.g., snake venom)
- Trauma
- Mechanical (heart valves, extensive vascular surgery, microvascular disease)
- Microangiopathic hemolytic anemia (a specific subtype with causes such as TTP, HUS, DIC and HELLP syndrome)
- Infections
- Membrane disorders
- Paroxysmal nocturnal hemoglobinuria (rare acquired clonal disorder of red blood cell surface proteins)
- Liver disease
References
- ↑ Berentsen S, Sundic T (2015). "Red blood cell destruction in autoimmune hemolytic anemia: role of complement and potential new targets for therapy". Biomed Res Int. 2015: 363278. doi:10.1155/2015/363278. PMC 4326213. PMID 25705656.