Sandbox:DD HA

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DD of hemolytic anemia

Characterisitc/Parameter Etiology Mean corpuscular volume Laboratory abnormalities Physical examination Treatment Other associated abnormalities
Hemolytic anemia
  • Drug-induced
  • Immune-mediated
  • Non-immune-mediated
  • Infections
  • Rheumatologic disease
  • Normocytic (80-100 femtoliter)
  • Indirect hyperbilirubinemia
  • Reticulocytosis
  • Low haptoglobin
  • Elevated LDH
  • Pallor
  • Jaundice
Sideroblastic anemia
  • Alcoholism
  • Lead poisoning
  • Vitamin B6 deficiency
  • Isoniazid
  • Chloramphenicol
  • Microcytic (<80 femtoliter)

Or

  • Normocytic (80-100 femtoliter)
  • Ringed sideroblasts in bone marrow
  • Low vitamin B6 level
  • High lead level
  • Pallor
  • Weakness
Anemia of chronic disease
  • Chronic kidney disease
  • Rheumatologic disease
  • Cancer
  • HIV
  • Chronic infection; excess release of IL-1 and IL-6
  • Normocytic (80-100 femtoliter)
  • Elevated ESR and CRP
  • Elevated hepcidin
  • Low serum iron
  • Low transferrin
  • Elevated ferritin
Thalassemia
  • Genetic defect with alpha- or beta-globin production
  • Microcytic (<80 femtoliter)
  • Abnormal hemoglobin electrophoresis (in beta-thalassemia)
Iron deficiency anemia
  • Loss of iron from gastrointestinal blood loss or menstrual blood loss
  • Microcytic (<80 femtoliter)
  • Low serum iron
  • Elevated transferrin
  • Low transferrin saturation
  • Low ferritin
Erythropoietin deficiency
  • Chronic kidney disease or other renal dysfunction
  • Normocytic (80-100 femtoliter)
  • Low erythropoietin level
Vitamin B12 or folate deficiency
  • Pernicious anemia
  • Diphyllobothrium latum infection
  • Nutritional deficiency
  • Crohn's disease of terminal ileum
  • Macrocytic (>100 femtoliter)
  • Low vitamin B12 or folate level
  • Megaloblastic anemia with hypersegmented neutrophils