Haemolytic anaemia

Question 1

What is haemolytic anaemia?

Answer 1

Haemolytic anaemia encompasses a number of conditions that result in the premature destruction of RBCs.

Common causes include autoantibodies, medications, and underlying malignancy, but the condition can also result from a number of hereditary conditions, such as haemoglobinopathies.

Question 2

What are the risk factors for haemolytic anaemia?

Answer 2

> Autoimmune disorders
> Lymphoproliferative disorders
> Prosthetic heart valve
> Family are mediterranean, Middle east, sub saharan africa or SE asia
> FHx of haemoglobinopathies
> Paroxysmal nocturnal haemoglobinuria
> Recent cephalasporins, peniccilins, quinine derivatives and NSAIDs
> Exposure to Napthalene or fava beans
> Thermal injuries

Question 3

What are the signs and symptoms of haemolytic anaemia?

Answer 3

> Pallor
> Jaundice
> Fatigue
> SOB
> Dizziness
> Splenomegaly
> Infections, dark urine

Question 4

What is the epidemiology of haemolytic anaemia?

Answer 4

The epidemiology of haemolytic anaemia varies with underlying cause. Glucose-6-phosphate dehydrogenase deficiency, for example, is an X-linked defect in enzyme metabolism causing haemolysis after illness or certain drugs

Warm antibody haemolytic anaemia is the most common haemolytic anaemia with an autoimmune cause, and it affects more women than men

Question 5

What investigations would you do for haemolytic anaemia?

Answer 5

> FBC- low Hb
> MCHC- High
> Reticulocyte count- high
> Peripheral smear- schistocytes, spherocytes, elliptocytes, tear drop cells etc.
> Unconj BR- high
> LDH- high
> Haptoglobin- low
> Urinalysis- + for blood no RBC