Hemolytic anemia resident survival guide: Difference between revisions
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== Causes == | == Causes == | ||
*Intraerythrocytic causes | *'''Intraerythrocytic causes''' | ||
# Membrane cytoskeletal defects<ref name="pmid21251470">{{cite journal| author=Barcellini W, Bianchi P, Fermo E, Imperiali FG, Marcello AP, Vercellati C | display-authors=etal| title=Hereditary red cell membrane defects: diagnostic and clinical aspects. | journal=Blood Transfus | year= 2011 | volume= 9 | issue= 3 | pages= 274-7 | pmid=21251470 | doi=10.2450/2011.0086-10 | pmc=3136593 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21251470 }} </ref> | # '''Membrane cytoskeletal defects'''<ref name="pmid21251470">{{cite journal| author=Barcellini W, Bianchi P, Fermo E, Imperiali FG, Marcello AP, Vercellati C | display-authors=etal| title=Hereditary red cell membrane defects: diagnostic and clinical aspects. | journal=Blood Transfus | year= 2011 | volume= 9 | issue= 3 | pages= 274-7 | pmid=21251470 | doi=10.2450/2011.0086-10 | pmc=3136593 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21251470 }} </ref> | ||
#* [[Hereditary spherocytosis]] | #* [[Hereditary spherocytosis]] | ||
#* [[Hereditary stomatocytosis]] | #* [[Hereditary stomatocytosis]] | ||
#* [[Hereditary elliptocytosis]] | #* [[Hereditary elliptocytosis]] | ||
#* [[Hereditary pyropoikilocytosis]] | #* [[Hereditary pyropoikilocytosis]] | ||
# Enzyme defects | # '''Enzyme defects''' | ||
#* [[Glucose 6 phosphate dehydrogenase deficiency]] | #* [[Glucose 6 phosphate dehydrogenase deficiency]] | ||
#* [[Pyruvate kinase deficiency]] | #* [[Pyruvate kinase deficiency]] | ||
#Hemoglobinopathies | #'''Hemoglobinopathies''' | ||
#* [[Sickle cell disease]] | #* [[Sickle cell disease]] | ||
#* [[Thalassemia]] | #* [[Thalassemia]] | ||
#* [[Congenital dyserythropoietic anemia]] | #* [[Congenital dyserythropoietic anemia]] | ||
#[[Paroxysmal nocturnal hemoglobinuria]] | #'''[[Paroxysmal nocturnal hemoglobinuria]]''' | ||
*Extraerythrocytic causes | *'''Extraerythrocytic causes''' | ||
**Immune causes | **'''Immune causes''' | ||
# Autoimmune hemolytic anemia | # '''Autoimmune hemolytic anemia''' | ||
#* Warm agglutinin disease | #* Warm agglutinin disease | ||
#* [[Cold agglutinin disease]] | #* [[Cold agglutinin disease]] | ||
# Isoimmune hemolytic anemia | # '''Isoimmune hemolytic anemia''' | ||
#* [[ABO group incompatible blood transfusion]] | #* [[ABO group incompatible blood transfusion]] | ||
#* [[Rhesus group incompatible blood transfusion]] | #* [[Rhesus group incompatible blood transfusion]] | ||
#Drug induced hemolytic anemia | #'''Drug induced hemolytic anemia''' | ||
#* [[Cephalosporins]] (most common) | #* [[Cephalosporins]] (most common) | ||
#* [[Penicillin]] | #* [[Penicillin]] | ||
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#* [[NSAIDs]] | #* [[NSAIDs]] | ||
#* [[Nitrofurantoin]] etc | #* [[Nitrofurantoin]] etc | ||
** Non-immune causes | ** '''Non-immune causes''' | ||
# Microangiopathic hemolytic anemia | # '''Microangiopathic hemolytic anemia''' | ||
#* [[Hemolytic uremic syndrome]] | #* [[Hemolytic uremic syndrome]] | ||
#* [[Thrombotic thrombocytopenia purpura]] | #* [[Thrombotic thrombocytopenia purpura]] | ||
#* [[Systemic lupus erythematosus]] | #* [[Systemic lupus erythematosus]] | ||
#* [[Disseminated intravascular coagulation]] | #* [[Disseminated intravascular coagulation]] | ||
# Macroangiopathic hemolytic anemia | # '''Macroangiopathic hemolytic anemia''' | ||
#* [[Prosthetic heart valve]]s | #* [[Prosthetic heart valve]]s | ||
#* [[Aortic stenosis]] | #* [[Aortic stenosis]] | ||
| Line 74: | Line 74: | ||
#* [[Dialysis]] | #* [[Dialysis]] | ||
#* Exertional hemolysis eg., during exercise | #* Exertional hemolysis eg., during exercise | ||
# Infections/ Toxins | # '''Infections/ Toxins''' | ||
#* [[Malaria]] | #* [[Malaria]] | ||
#* [[Bartonellosis]] | #* [[Bartonellosis]] | ||
| Line 80: | Line 80: | ||
#* [[CMV]] | #* [[CMV]] | ||
#* Hemotoxic [[snake bite]] venom | #* Hemotoxic [[snake bite]] venom | ||
# [[Hypersplenism]] | # '''[[Hypersplenism]]''' | ||
# Liver disease | # '''Liver disease''' | ||
== FIRE == | == FIRE == | ||
Revision as of 18:01, 29 July 2020
| Hemolytic anemia Resident Survival Guide |
|---|
| Overview |
| Causes |
| FIRE |
| Diagnosis |
| Treatment |
| Do's |
| Don'ts |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];
Overview
- Anemia is defined as a decrease in red blood cell population in the body.
- Hemolytic anemia results from a destruction of RBCs which is faster than the bone marrow production of them. Hemolysis can be due to either extravascular or intravascular destruction of cells[1].
- It is caused due to a wide variety of reasons which include inherited diseases like thalassemia, sickle cell disease etc, infections, autoimmune conditions, bone marrow dysfunction, blood transfusions and certain drugs can also result in hemolytic anemia [2].
- Most common presenting symptoms are fatigue, palpitations, dyspnea, tachycardia and icterus in severe cases.
- Diagnosis usually requires a battery of tests including, but not limited to a peripheral smear, CBC, serum LDH, bone marrow studies, etc.
- Treatment is directed by the specific cause and can involve bone marrow transplant, splenectomy, transfusions etc[3].
Causes
- Intraerythrocytic causes
- Membrane cytoskeletal defects[4]
- Enzyme defects
- Hemoglobinopathies
- Paroxysmal nocturnal hemoglobinuria
- Extraerythrocytic causes
- Immune causes
- Autoimmune hemolytic anemia
- Warm agglutinin disease
- Cold agglutinin disease
- Isoimmune hemolytic anemia
- Drug induced hemolytic anemia
- Cephalosporins (most common)
- Penicillin
- Dapsone
- Methyldopa
- NSAIDs
- Nitrofurantoin etc
- Non-immune causes
- Microangiopathic hemolytic anemia
- Macroangiopathic hemolytic anemia
- Prosthetic heart valves
- Aortic stenosis
- Malignant hypertension
- Pre-eclampsia
- Dialysis
- Exertional hemolysis eg., during exercise
- Infections/ Toxins
- Malaria
- Bartonellosis
- Hepatitis
- CMV
- Hemotoxic snake bite venom
- Hypersplenism
- Liver disease
FIRE
Diagnosis
Treatment
Do's
Don'ts
References
- ↑ Phillips J, Henderson AC (2018). "Hemolytic Anemia: Evaluation and Differential Diagnosis". Am Fam Physician. 98 (6): 354–361. PMID 30215915.
- ↑ Renard D, Rosselet A (2017). "Drug-induced hemolytic anemia: Pharmacological aspects". Transfus Clin Biol. 24 (3): 110–114. doi:10.1016/j.tracli.2017.05.013. PMID 28648734.
- ↑ Morishita E (2015). "[Diagnosis and treatment of microangiopathic hemolytic anemia]". Rinsho Ketsueki. 56 (7): 795–806. doi:10.11406/rinketsu.56.795. PMID 26251142.
- ↑ Barcellini W, Bianchi P, Fermo E, Imperiali FG, Marcello AP, Vercellati C; et al. (2011). "Hereditary red cell membrane defects: diagnostic and clinical aspects". Blood Transfus. 9 (3): 274–7. doi:10.2450/2011.0086-10. PMC 3136593. PMID 21251470.