Hemolytic anemia: Difference between revisions
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In [[hematology]], '''{{PAGENAME}}''' is an "A condition of inadequate circulating red blood cells ([[anemia]]) or insufficient hemoglobin due to premature destruction of red blood cells ([[erythrocyte]]s)."<ref>{{MeSH}}</ref> | In [[hematology]], '''{{PAGENAME}}''' is an "A condition of inadequate circulating red blood cells ([[anemia]]) or insufficient hemoglobin due to premature destruction of red blood cells ([[erythrocyte]]s)."<ref>{{MeSH}}</ref> | ||
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Hemolysis | Hemolysis | ||
* [[Haptoglobin]]'s role in diagnosis has been reviewed.<ref name="pmid24809098">{{cite journal| author=Shih AW, McFarlane A, Verhovsek M| title=Haptoglobin testing in hemolysis: measurement and interpretation. | journal=Am J Hematol | year= 2014 | volume= 89 | issue= 4 | pages= 443-7 | pmid=24809098 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24809098 }} </ref> Its accuracy is:<ref name="pmid7365971">{{cite journal| author=Marchand A, Galen RS, Van Lente F| title=The predictive value of serum haptoglobin in hemolytic disease. | journal=JAMA | year= 1980 | volume= 243 | issue= 19 | pages= 1909-11 | pmid=7365971 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7365971 }} </ref> | * [[Haptoglobin]]'s role in diagnosis has been reviewed.<ref name="pmid24809098">{{cite journal| author=Shih AW, McFarlane A, Verhovsek M| title=Haptoglobin testing in hemolysis: measurement and interpretation. | journal=Am J Hematol | year= 2014 | volume= 89 | issue= 4 | pages= 443-7 | pmid=24809098 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24809098 }} </ref><ref name="pmid7431603">{{cite journal| author=Rice L| title=Serum haptoglobin in hemolytic disease. | journal=JAMA | year= 1980 | volume= 244 | issue= 23 | pages= 2607-8 | pmid=7431603 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7431603 }} </ref> Its accuracy is:<ref name="pmid7365971">{{cite journal| author=Marchand A, Galen RS, Van Lente F| title=The predictive value of serum haptoglobin in hemolytic disease. | journal=JAMA | year= 1980 | volume= 243 | issue= 19 | pages= 1909-11 | pmid=7365971 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7365971 }} </ref> | ||
** [[Sensitivity and specificity|Sensitivity]] 83% | ** [[Sensitivity and specificity|Sensitivity]] 83% | ||
** [[Sensitivity and specificity|Specificity]] 96% | ** [[Sensitivity and specificity|Specificity]] 96% | ||
* [[Lactate dehydrogenase]] | * [[Lactate dehydrogenase]] | ||
* | * Bilirubin may not be very sensitive.<ref>Pirofsky B. Autoimmunization and the autoimmune hemolytic anemias. Baltimore; Williams & Wilkins: 1969:44-72</ref> | ||
* [[Reticulocyte count]] | * [[Reticulocyte count]]<ref name="pmid3814817">{{cite journal| author=Liesveld JL, Rowe JM, Lichtman MA| title=Variability of the erythropoietic response in autoimmune hemolytic anemia: analysis of 109 cases. | journal=Blood | year= 1987 | volume= 69 | issue= 3 | pages= 820-6 | pmid=3814817 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3814817 }} </ref> | ||
* Peripheral smear | * Peripheral smear<ref name="pmid16079373">{{cite journal| author=Bain BJ| title=Diagnosis from the blood smear. | journal=N Engl J Med | year= 2005 | volume= 353 | issue= 5 | pages= 498-507 | pmid=16079373 | doi=10.1056/NEJMra043442 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16079373 }} </ref> | ||
Autoimmunity: | Autoimmunity: | ||
* Red-blood-cell-bound [[immunoglobulin]] G<ref name="pmid19105232">{{cite journal| author=Kamesaki T, Oyamada T, Omine M, Ozawa K, Kajii E| title=Cut-off value of red-blood-cell-bound IgG for the diagnosis of Coombs-negative autoimmune hemolytic anemia. | journal=Am J Hematol | year= 2009 | volume= 84 | issue= 2 | pages= 98-101 | pmid=19105232 | doi=10.1002/ajh.21336 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19105232 }} </ref> | * Red-blood-cell-bound [[immunoglobulin]] G<ref name="pmid19105232">{{cite journal| author=Kamesaki T, Oyamada T, Omine M, Ozawa K, Kajii E| title=Cut-off value of red-blood-cell-bound IgG for the diagnosis of Coombs-negative autoimmune hemolytic anemia. | journal=Am J Hematol | year= 2009 | volume= 84 | issue= 2 | pages= 98-101 | pmid=19105232 | doi=10.1002/ajh.21336 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19105232 }} </ref> | ||
* [[Coombs' test]], using the direct method, may have 97% sensitivity for detecting warm antibodies.<ref name="pmid4567200">{{cite journal| author=Worlledge SM, Blajchman MA| title=The autoimmune haemolytic anaemias. | journal=Br J Haematol | year= 1972 | volume= 23 | issue= | pages= Suppl:61-9 | pmid=4567200 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4567200 }} </ref> | * [[Coombs' test]], using the direct method, may have 97% sensitivity for detecting warm antibodies.<ref name="pmid4567200">{{cite journal| author=Worlledge SM, Blajchman MA| title=The autoimmune haemolytic anaemias. | journal=Br J Haematol | year= 1972 | volume= 23 | issue= | pages= Suppl:61-9 | pmid=4567200 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4567200 }} </ref><ref name="pmid6034957">{{cite journal| author=Allgood JW, Chaplin H| title=Idiopathic acquired autoimmune hemolytic anemia. A review of forty-seven cases treated from 1955 through 1965. | journal=Am J Med | year= 1967 | volume= 43 | issue= 2 | pages= 254-73 | pmid=6034957 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6034957 }} </ref> | ||
Microangiopathic hemolytic anemia | Microangiopathic hemolytic anemia | ||
* [[Platelet count]] | |||
* ADAMTS13 protein activity and inhibitor (von Willebrand factor-degrading protease)<ref name="pmid20032506">{{cite journal| author=Kremer Hovinga JA, Vesely SK, Terrell DR, Lämmle B, George JN| title=Survival and relapse in patients with thrombotic thrombocytopenic purpura. | journal=Blood | year= 2010 | volume= 115 | issue= 8 | pages= 1500-11; quiz 1662 | pmid=20032506 | doi=10.1182/blood-2009-09-243790 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20032506 }} </ref> | * ADAMTS13 protein activity and inhibitor (von Willebrand factor-degrading protease)<ref name="pmid20032506">{{cite journal| author=Kremer Hovinga JA, Vesely SK, Terrell DR, Lämmle B, George JN| title=Survival and relapse in patients with thrombotic thrombocytopenic purpura. | journal=Blood | year= 2010 | volume= 115 | issue= 8 | pages= 1500-11; quiz 1662 | pmid=20032506 | doi=10.1182/blood-2009-09-243790 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20032506 }} </ref> | ||
==References== | ==References== | ||
<references/> | <references/> | ||
Latest revision as of 11:51, 8 September 2020
In hematology, Hemolytic anemia is an "A condition of inadequate circulating red blood cells (anemia) or insufficient hemoglobin due to premature destruction of red blood cells (erythrocytes)."[1]
Classification
One classification is based on whether hemolysis occurs intravascularly or extravascularly. Another classification is whether the erythrocytes are intrinsically normal:[2]
Hemolytic anemia associated with normal red cells
- Autoimmune hemolytic anemia
- Direct antiglobulin ("Coombs") test-negative
- Direct antiglobulin ("Coombs") test-positive
- Cold agglutinin disease[3]
- Complement-induced lysis
- Microangiopathic hemolytic anemia. Includes Thrombotic thrombocytopenic purpura.
- Others
Hemolytic anemia associated with abnormal red cells
- Hemoglobinopathies. Includes Sickle cell anemia.
- Metabolic deficiency
- Erythrocyte membrane abnormality. Includes Hereditary spherocytosis.
- Others
Diagnosis
Hemolysis
- Haptoglobin's role in diagnosis has been reviewed.[4][5] Its accuracy is:[6]
- Sensitivity 83%
- Specificity 96%
- Lactate dehydrogenase
- Bilirubin may not be very sensitive.[7]
- Reticulocyte count[8]
- Peripheral smear[9]
Autoimmunity:
- Red-blood-cell-bound immunoglobulin G[10]
- Coombs' test, using the direct method, may have 97% sensitivity for detecting warm antibodies.[11][12]
Microangiopathic hemolytic anemia
- Platelet count
- ADAMTS13 protein activity and inhibitor (von Willebrand factor-degrading protease)[13]
References
- ↑ Anonymous (2024), Hemolytic anemia (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Wright DE, Rosovsky RP, Platt MY (2013). "Case records of the Massachusetts General Hospital. Case 36-2013. A 38-year-old woman with anemia and thrombocytopenia.". N Engl J Med 369 (21): 2032-43. DOI:10.1056/NEJMcpc1215972. PMID 24256382. Research Blogging.
- ↑ Berentsen S, Tjønnfjord GE (2012). "Diagnosis and treatment of cold agglutinin mediated autoimmune hemolytic anemia.". Blood Rev 26 (3): 107-15. DOI:10.1016/j.blre.2012.01.002. PMID 22330255. Research Blogging.
- ↑ Shih AW, McFarlane A, Verhovsek M (2014). "Haptoglobin testing in hemolysis: measurement and interpretation.". Am J Hematol 89 (4): 443-7. PMID 24809098. [e]
- ↑ Rice L (1980). "Serum haptoglobin in hemolytic disease.". JAMA 244 (23): 2607-8. PMID 7431603. [e]
- ↑ Marchand A, Galen RS, Van Lente F (1980). "The predictive value of serum haptoglobin in hemolytic disease.". JAMA 243 (19): 1909-11. PMID 7365971. [e]
- ↑ Pirofsky B. Autoimmunization and the autoimmune hemolytic anemias. Baltimore; Williams & Wilkins: 1969:44-72
- ↑ Liesveld JL, Rowe JM, Lichtman MA (1987). "Variability of the erythropoietic response in autoimmune hemolytic anemia: analysis of 109 cases.". Blood 69 (3): 820-6. PMID 3814817. [e]
- ↑ Bain BJ (2005). "Diagnosis from the blood smear.". N Engl J Med 353 (5): 498-507. DOI:10.1056/NEJMra043442. PMID 16079373. Research Blogging.
- ↑ Kamesaki T, Oyamada T, Omine M, Ozawa K, Kajii E (2009). "Cut-off value of red-blood-cell-bound IgG for the diagnosis of Coombs-negative autoimmune hemolytic anemia.". Am J Hematol 84 (2): 98-101. DOI:10.1002/ajh.21336. PMID 19105232. Research Blogging.
- ↑ Worlledge SM, Blajchman MA (1972). "The autoimmune haemolytic anaemias.". Br J Haematol 23: Suppl:61-9. PMID 4567200. [e]
- ↑ Allgood JW, Chaplin H (1967). "Idiopathic acquired autoimmune hemolytic anemia. A review of forty-seven cases treated from 1955 through 1965.". Am J Med 43 (2): 254-73. PMID 6034957. [e]
- ↑ Kremer Hovinga JA, Vesely SK, Terrell DR, Lämmle B, George JN (2010). "Survival and relapse in patients with thrombotic thrombocytopenic purpura.". Blood 115 (8): 1500-11; quiz 1662. DOI:10.1182/blood-2009-09-243790. PMID 20032506. Research Blogging.