Acquired Haemolytic Anaemia

Question 1

Immune Haemolytic Anaemia

Answer 1

acquired
antibody mediated destruction of erythrocytes

two categories warm and cold

Question 2

Warm Haemolytic Anaemia

Answer 2

pathologic antibodies against red cells are active at normal body temperatures

pallor
jaundice

decreased haptoglobin
direct coombs test is positive

IgG mediated

transfusions
splenectomy
immune suppresion with glucocorticoids

Question 3

Cold haemolytic Anaemia

Answer 3

pathologic antibodies against red cells are active at below normal body temperatures

erythrocytes are coated with IgM at lower temps leading to agglutination and microvascular diseaes
complement mediated destuction follows

cyanosis
ischaemia
anaemia

cold avoidance

Question 4

Microangiopathic Haemolytic anaemia (MAHA)

Answer 4

shear damage to erythrocytes due to endothilial cell damage.

non immune, coombs negative
shistiocytes on blood smear

seen in
vasculitis
eclampsia
HELLP
hypersplenism
prosthetic heart valves

Question 5

Paroxysmal nocturnal hemoglobinuria

Answer 5

acquired anaemia
abnormal cells deficient in PIG-A gene
lose protection from complement activation
compliment mediated destruction

often note haematuria in the morning

associated with abnormal clotting

transfusions
eculizumab