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Clinical Hematological: Assist Prof. Dr. Mudhir S. Shekha
Clinical Hematological: Assist Prof. Dr. Mudhir S. Shekha
Clinical Hematological: Assist Prof. Dr. Mudhir S. Shekha
haemolytic anaemias
Congenital Acquired
• Haemoglobinopathies • Autoimmune
— sickle cell disease • Non-immune
— thalassaemia
• membrane defects — Microangiopathic
— spherocytosis haemolytic anaemia
— elliptocytosis — Prosthetic heart valve
• red cell enzyme defects — Drug or toxin induced.
— glucose 6-phosphate dehydrogenase
deficiency
Causes
Intrinsic causes
• Defects of red blood cell membrane production
• Defects in hemoglobin production
• Defective red cell metabolism
Extrinsic causes
• Immune-mediated causes
• Paroxysmal nocturnal hemoglobinuria
• hypersplenism
• burns
• Lead poisoning
• footstrike hemolysis
• Low-grade hemolytic anemia
Diagnosis
1. Peripheral blood smear microscopy
schistocytes, spherocytes, Reticulocytes,
Bite cells (Heinz body)
2. Increased LDH.
3. Increased indirect bilirubin (unconjugated ).
4. Increased reticulocyte count
5. Decreased haptoglobin.
6. Haemosiderin can be detected in urine.
7. direct Coombs test is positive autoimmune
hemolytic anemia
8. Haemaglobinuria PNH
Hereditary Spherocytosis
Minkowski–Chauffard syndrome