Hemolytic anemia differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Differentiating Hemolytic anemia from other Diseases
- Ineffective hematopoiesis is sometimes misdiagnosed as hemolysis.
- Clinically these conditions may share many features of hemolysis
- Red cell breakdown occurs before a fully developed red cell is released into the circulation.
- Examples: thalassemia, myelodysplastic syndrome
- Megaloblastic anemia due to deficiency in vitamin B12 or folic acid.
Differentiating Drug-Induced Autoimmune Hemolytic Anemia from other Diseases
Penicillin in high doses can induce immune mediated hemolysis[1] via the hapten mechanism in which antibodies are targeted against the combination of penicillin in association with red blood cells. Complement is activated by the attached antibody leading to the removal of red blood cells by the spleen.
The drug itself can be targeted by the immune system, e.g. by IgE in a Type I hypersensitivity reaction to penicillin, rarely leading to anaphylaxis.
References
- ↑ Stroncek D, Procter JL, Johnson J (2000). <67::AID-AJH12>3.0.CO;2-Z "Drug-induced hemolysis: cefotetan-dependent hemolytic anemia mimicking an acute intravascular immune transfusion reaction". Am. J. Hematol. 64 (1): 67–70. PMID 10815791. Unknown parameter
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