Acquired hemolytic anemia

Acquired hemolytic anemia can be divided into immune and non-immune mediated forms of hemolytic anemia.

Acquired hemolytic anemia
SpecialtyHematology

Immune

Immune mediated hemolytic anaemia (direct Coombs test is positive)

Non-immune

Non-immune mediated hemolytic anemia (direct Coombs test is negative)

  • Drugs (i.e., some drugs and other ingested substances lead to hemolysis by direct action on RBCs, e.g., ribavirin )
  • Toxins (e.g., snake venom; plant poisons such as aesculin)
  • Trauma
    • Mechanical (from heart valves, extensive vascular surgery, microvascular disease, repeated mechanical vascular trauma)
  • Microangiopathic hemolytic anaemia (a specific subtype with causes such as TTP, HUS, DIC and HELLP syndrome)
  • Infections (Note: Direct Coombs test is sometimes positive in hemolytic anaemia due to infection)
  • Membrane disorders

Drug induced hemolysis

Drug induced hemolysis has large clinical relevance. It occurs when drugs actively provoke red blood cell destruction. It can be divided in the following manner:

A total of four mechanisms are usually described, but there is some evidence that these mechanisms may overlap.[1]

References

  1. Wright MS (1999). "Drug-induced hemolytic anemias: increasing complications to therapeutic interventions". Clin Lab Sci. 12 (2): 115–8. PMID 10387489.
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