Tuesday, March 9, 2010

Hemolytic anemia

Hemolytic anemia - Chronic

Definition  

Shortened RBC survival in the peripheral blood before the normal life span of 120 days, manifested as anemia when RBC production is unable to match the rate of RBC destruction


 

Findings  

* Pallor

* Jaundice

* Dyspnea - Chronic

* Tachycardia

* Oliguria and anuria

* Urine looks dark

* Fatigue

* Pain

* Seizure


 

Tests  


 

Suspected hemolytic anemia  

* Complete blood count with white cell differential, automated


 

Suspected hemolytic anemia  

* Reticulocyte count


 

Suspected hemolytic anemia  

* Peripheral blood smear interpretation


 

Suspected hemolytic anemia  

* Plasma unconjugated bilirubin measurement

* LDH blood measurement

* Measurement of total hemoglobin concentration in urine specimen


 

Suspected hemolytic anemia  

* Iron measurement, urine


 

Suspected hemolytic anemia  

* Serum haptoglobin measurement: Low serum haptoglobin levels occur in both intravascular and extravascular hemolytic anemia .


 

Suspected immune hemolytic anemia  

* Direct Coombs test


 

Suspected hemoglobinopathy  

* Hemoglobin electrophoresis


 

Differential Diagnosis  

* Sickle cell anemia - Chronic

* Thalassemia - Chronic

* Hemolytic disease of fetus OR newborn due to isoimmunization

* Warm autoimmune hemolytic anemia

* Cold autoimmune hemolytic anemia

* Disseminated intravascular coagulation

* Hemolytic uremic syndrome

* Thrombotic thrombocytopenic purpura

* Hereditary spherocytosis

* Hereditary elliptocytosis

* Deficiency of pyruvate kinase

* Deficiency of glucose-6-phosphate dehydrogenase

* Transfusion reaction due to isoantibody

* Drug-induced immune hemolytic anemia

* Traumatic cardiac hemolytic anemia

* Paroxysmal nocturnal hemoglobinuria

* Paroxysmal cold hemoglobinuria


 

Treatment  


 

Drug Therapy  


 


 

Chronic hemolysis in patients with hemolytic anemia  


 

FOLIC ACID  

Adults: Up to 1 mg/day orally, IM, or IV; maintenance dose 0.4 mg/day orally

Adults (pregnant and lactating women): 0.8 mg/day orally


 

Warm autoimmune hemolytic anemia  


 

PREDNISONE  

1 comment:

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SYSTEM BASED CLASSIFICATION OF DISEASES

SYSTEM BASED CLASSIFICATION OF DISEASES

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Gynecologic and Obstetric Diseases

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Hematologic Diseases

  1. Anemia
    1. Megaloblastic Anemia

i. Megaloblastic Anemia due to Folate Deficiency

ii. Megaloblastic Anemia due to Vitamine B12 Deficiency

    1. Sickle Cell anemia
    2. Hemolytic Anemia
    3. Iron Deficiency Anemia
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