HAEMOLYSIS

Question 1

DESCRIBE THE CLINICAL CONSEQUENCES OF IVH HAEMOLYSIS

IVH- Intravascular Haemolysis

Answer 1

1. Anaemia due to Iron Deficiency
2. Leg Ulcers
3. Megaloblastic Anaemia
4. Arterial Renal Failure
5. Pulmonary Hypertension

Question 2

Laboratory tests

List the laboratory findings in Intravascular haemolysis

Answer 2

1. Decreased Haptoglobin
2. Plasma Hb
3. Haemoglobinuria
4. Haemosiderinuria (Haemo-side-rin-uria)
5. Increased LDH

Question 3

DESCRIBE/LIST THE CLINICAL CONDITIONS WITH PREDOMINANT INTRAVASCULAR HAEMOLYSIS

Answer 3

1. Malaria
2. Sickle Cell Disease (SCD)
3. Cold Autoimmune Haemolytic Anaemia
4. Immediate Blood Transfusion Reaction
5. Paroxysmal Nocturnal Haemoglobinuria
6. Macro/Micro- Angiopathic Haemolytic Anaemia

Question 4

Describe the Clinical Consequences Of Extravascular Haemolysis

Remeber extravascular occurs outside blood vessels( in spleen, liver…)

Answer 4

1.Anaemia
2.Splenomegaly
3.Leg Ulcers
4.Jaundice
5.Gall Stones
6.Iron Overload
7.Megaloblastic Anaemia
8.Pulmonary Hypertension

Question 5

Lab Tests for EVH

Describe the Lab Test FIndings that could indicate Extravascular Haemolysis.

Answer 5

1. Increased Unconjugated Bilirubin (acholuric Jaundice)
2. Increased LDH
3. Decreased Serum Haptoglonin

Question 6

Discuss the Clinical Conditions with predominant Extravascular Haemolysis

Answer 6

1. Beta thalassaemia major.
2. HbH disease.
3. Hereditary Spherocytosis.
4. Warm Auto-Immune Haemolytic Anaemia.
5. Delayed Blood Transfussion Reaction.

Question 7

Describe the differences in clinical features in EVH and IVH

Answer 7

1. both have Anaemia
2. There’s Iron deficiency in Intravascular and Iron Overload in Extravascular
3. There’s Jaundice in Extravascular and NO JAUNDICE in Intravascular
4. NO Zinc Deficiency in Extravascular and Zinc Deficiency in present in Intravascular
5. There’s definitely present Gall Stones in extravascular
6. There’s Definitely present Pulmonary Hypertension in Intravascular

Question 8

Discuss the causes of Microangiopathic Haemolysis

Answer 8

1. Disseminated Intravascular Coagulation
2. Thrombotic Thrombocytopenic Purpura (TTP)
3. Haemolytic Uraemic Syndrome
4. Malignant Hypertension
5. Disseminated Carcinoma
6. Immunogenic Vasculitis, eg, SLE
7. Giant Haemangioma

Question 9

Describe the Pathogenesis and Clinical Features of Hereditary Spherocytosis

Answer 9

Pathogenesis
The red cell assumes a spherical shape due to the loss of typical biconcave conformation

The clinical presentation is variable, but patients with HS will typically have Splenomegaly and Fluctuating Jaundice