Haem - haemolytic anaemia + anaemia generally Flashcards
Causes of extravascular haemolytic anaemia?
Autoimmune causes + hereditary spherocytosis
Features of intravascular haemolytic anaemia?
Dark red urine (haemoglobinuria) Low haptoglobin (binds free Hb)
Inherited causes of haemolytic anaemia
Membrane: spherocytosis, elliptocytosis
Enzyme: G6PD, pyruvate kinase deficiency
Hb: sickle cell, thalassemia
Acquired causes of haemolytic anaemia
Immune or non-immune
Immune: Autoimmune(hot or cold) or alloimmune
Non-immune: malaria, MECHANICAL, PNH, MAHA
Which test should be done to determine if haemolytic anaemia is immune or non-immune?
DAT test
Warm autoimmune haemolytic anaemia.
List 5 causes?
Idiopathic - most common Lymphoma CLL SLE methyldopa
3 point plan re management of warm autoimmune haemolytic anaemia?
Steroids
Splenectomy
Immunosuppression
Which Ig class is implicated in warm AIHA? and in cold AIHA?
Warm = IgG Cold = IgM
4 causes of cold agglutinin disease?
Idiopathic
Lymphoma
Mycoplasma
EBV
Which chemotherapy drug is used for cold agglutinin disease?
Chlorambucil
Management of PNH - 3 marks
1) Iron/folate supplements
2) Monoclonal Abs against complement
3) Prophylactic vaccines/Abx
MAHA - 4 causes?
HUS
TTP
DIC
Preeclampsia
Cause of HUS? How does MAHA develop?
E. Coli –> toxin damages endothelial cells
Fibrin mesh forms –> mechanical damage of RBCs!
Classical 5 features of TTP?
MAHA Fever renal failure Low plts Neuro abnormalities!!!! - not seen in HUS
3 features of HUS?
Haemolysis
Renal failure/uraemia
Thrombocytopenia