This document discusses hemolytic anemia, including its causes, signs and symptoms, pathophysiology, diagnosis, and investigation. The key points are: - Hemolytic anemia occurs when red blood cell destruction exceeds bone marrow production, shortening red blood cell lifespan from the normal 120 days to 20-30 days. - Causes include red blood cell defects like enzyme deficiencies or structural issues, as well as toxins, trauma, or conditions like thrombotic thrombocytopenic purpura. - Signs and symptoms include jaundice, pallor, splenomegaly, and dark urine. Diagnosis involves tests to detect hemolysis and determine the type and precise cause through

1. HEMOLYTIC ANAEMIA
DIAGNOSTIC HAEMATOLOGY
NAVINSHAN

2. LEARNING OUTCOMES
• The normal life-span & destruction of RBC
• Causes of Haemolytic anaemia
• Sign & Symptoms of Haemolytic anaemia
• Pathophysiology of Haemolytic anaemia
• Diagnosis of Haemolytic anaemia

3. Introduction
• RBC destruction is accelerated and exceeds
the maximum erythropoietic capacity of the
bone marrow
• RBC life span:
*Normal RBC : 120 days
*Hemolytic anaemia : 20-30 days

4. Causes
• RBC defects
*Enzyme dysfunction
*Haemoglobin abnormalities
• RBC Structure / Membrane defects
*Spherocytosis
*Eliptocytosis

5. • Other factors
*Chemical toxins
*Mechanical trauma
*Thrombotic thrombocytopenic purpura

6. Sign & Symptoms
• General symptoms of anaemia
*Jaundice
*Pallor
*Splenomegaly / Hepatosplenomegaly
*Dark urine

11. Pathophysiology
• Intravascular
Haemolysis
*Destruction of red cells
in the circulation,from a
damaged
endothelium(DIC,TTp &
etc),complement
activation and infectious
agents may cause direct
membrane destruction
• Extravascular
Haemolysis
*Removal of membrane
altered red cells by RE
system(macrophages of
spleen & liver), as in
hereditary Spherocytosis
and Elliptocytosis immune
haemolytic anaemia

15. History & Physical Examination
• Sign of anaemia may be discovered through
lab tests
• Dark urine & back pain indicate haemolysis
• Long history of jaundice may indicate
hereditary anaemia
• Lymphadenopathy & Splenomegaly
• History of infection ,drug ingestion &
carcinoma are important in suggesting the
cause

16. Diagnosis
• The investigation comprises several distinct
stages:
1)Existence of Haemolysis
2)Type of Haemolysis
3)Precise diagnosis

17. Evidence of Haemolysis
• Haemoglobin estimation
• Peripheral Blood Film
*Spherocytes
*Eliptocytes
*Schistocytes
• Reticulocytosis

18. • Biochemistry
*Unconjugated bilirubin
*Urobilinogen
*Urinary Haemoglobin
*Haptoglobin estimation

19. Type of Haemolysis
• DAT(Direct Coomb’s Test)
• Schumms Test (Plasma HB)
• Osmotic Fragility Test

20. Precise Diagnosis
• Investigation of incompatible transfusion
• Thalassemia / Hereditary Spherocytosis /
Hereditary Eliptocytosis-PBF(RBC morphology)