Haemolytic Anaemias

Question 1

Acquired haemolytic anaemias

Answer 1

• Immune mediated (autoimmune - warm and cold antibody type, transfusion reactions)
• Other (infections - malaria, chemical agents - lead, secondary - liver disease)

Question 2

Hereditary haemolytic anaemias

Answer 2

• Membrane - hereditary spherocytosis
• Metabolic - G6PD deficiency
• Hb - Sickle Cell

Question 3

Key features in history

Answer 3

• PC (change in skin colour, dark urine, abdominal pain, lethargy)
• PMHx (previous anaemia, recent infections)
• DHx (penicillin, quinine)
• FHx (anaemia)
• SHx (recent travel)

Question 4

Key features in examination

Answer 4

• Jaundice
• Pallor
• Hepatosplenomegaly
• Abdominal pain

Question 5

Investigations

Answer 5

• FBC (anaemia, raised reticulocyte count)
• U&Es (raised bilirubin, raised LDH, low haptoglobins)
• Urine (urobilinogen)
• Blood film (reticulocytosis, damaged RBCs)
• Direct antiglobulin test (Coomb’s test - positive indicates immune cause)