Acute Hemolytic Anemia

Acute Hemolytic Anemia is a topic covered in the Pocket ICU Management.

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First Things First (assess & treat for the following)

  • Characterized by premature RBC destruction greater than increased RBC production (erythrocytosis), spherocytosis without bleeding
  • Most cases are caused by extrinsic factors: drugs, exogenous antibodies, mechanical trauma, infections & toxins.
  • 50% of cases are idiopathic or primary and not associated with pre-existing disease.
  • Autoimmune hemolytic anemia has shortened RBC lifespan with positive Coombs’ test.
    • ≥80% of cases are of warm reactive autoantibodies of IgG subclass; the rest are cold reactive.
    • Hemolysis occurs when nonphagocytized RBCs take on a spherical shape, rendering them poorly deformable and rigid.
    • These acquired spherocytes make them apt to destruction.
  • Indirect hyperbilirubinemia is usually present and highly suggestive of hemolytic anemia.
  • Watch for signs of organ dysfunction.
  • Obtain early hematologic consult.

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Last updated: May 5, 2010