Hemolytic anemia differential diagnosis: Difference between revisions
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Characterisitc/Parameter | ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Characterisitc/Parameter | ||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology | ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology | ||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Mean corpuscular volume | ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Mean corpuscular volume | ||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Laboratory abnormalities | ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Laboratory abnormalities | ||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Treatment | ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Treatment | ||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other associated abnormalities | ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other associated abnormalities | ||
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* [[Rheumatologic disease]] | * [[Rheumatologic disease]] | ||
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* [[Normocytic anemia|Normocytic]] | * [[Pallor]] | ||
* [[Jaundice]] | |||
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* [[Normocytic anemia|Normocytic]] | |||
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* Indirect [[hyperbilirubinemia]] | * Indirect [[hyperbilirubinemia]] | ||
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* Low [[haptoglobin]] | * Low [[haptoglobin]] | ||
* Elevated [[LDH]] | * Elevated [[LDH]] | ||
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* Removal of offending agent | * Removal of offending agent | ||
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* [[Chloramphenicol]] | * [[Chloramphenicol]] | ||
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* [[Microcytic anemia|Microcytic]] | * [[Pallor]] | ||
* [[Normocytic anemia|Normocytic]] | * [[Muscle weakness|Weakness]] | ||
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* [[Microcytic anemia|Microcytic]] | |||
* [[Normocytic anemia|Normocytic]] | |||
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* Ringed sideroblasts in [[bone marrow]] | * Ringed sideroblasts in [[bone marrow]] | ||
* Low [[vitamin B6]] level | * Low [[vitamin B6]] level | ||
* High [[lead]] level | * High [[lead]] level | ||
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* Removal of offending [[medication]] | * Removal of offending [[medication]] | ||
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* Chronic infection; excess release of [[IL-1]] and [[IL-6]] | * Chronic infection; excess release of [[IL-1]] and [[IL-6]] | ||
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* [[Normocytic anemia|Normocytic]] | * [[Pallor]] | ||
* [[Weakness]] | |||
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* [[Normocytic anemia|Normocytic]] | |||
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* Elevated [[ESR]] and [[CRP]] | * Elevated [[ESR]] and [[CRP]] | ||
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* Low [[transferrin]] | * Low [[transferrin]] | ||
* Elevated [[ferritin]] | * Elevated [[ferritin]] | ||
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* Treatment of the underlying cause; [[erythropoiesis]]-stimulating agents | * Treatment of the underlying cause; [[erythropoiesis]]-stimulating agents | ||
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* [[Genetic defect]] with alpha- or [[beta-globin]] production | * [[Genetic defect]] with alpha- or [[beta-globin]] production | ||
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* [[Irritability]] | * [[Irritability]] | ||
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* [[Hepatomegaly]] | * [[Hepatomegaly]] | ||
* [[Splenomegaly]] | * [[Splenomegaly]] | ||
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* [[Microcytic]] | |||
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* Abnormal [[hemoglobin]] [[electrophoresis]] (in [[beta-thalassemia]]) | |||
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* [[Blood transfusion|Transfusion]] support | * [[Blood transfusion|Transfusion]] support | ||
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* Loss of [[iron]] from [[gastrointestinal]] blood loss or [[menstrual]] [[blood loss]] | * Loss of [[iron]] from [[gastrointestinal]] blood loss or [[menstrual]] [[blood loss]] | ||
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* [[ | * [[Pallor]] | ||
* [[Weakness]] | |||
* Positive [[occult blood]] testing (if [[Gastrointestinal bleeding|GI bleeding]]) | |||
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* [[Microcytic]] | |||
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* Low serum [[iron]] | * Low serum [[iron]] | ||
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* Low [[transferrin saturation]] | * Low [[transferrin saturation]] | ||
* Low [[ferritin]] | * Low [[ferritin]] | ||
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* Intravenous or oral iron supplementation | * Intravenous or oral iron supplementation | ||
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* [[Chronic kidney disease]] or other [[renal dysfunction]] | * [[Chronic kidney disease]] or other [[renal dysfunction]] | ||
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* [[Pallor]] | * [[Pallor]] | ||
* [[Weakness]] | * [[Weakness]] | ||
* Signs of [[chronic kidney disease]] | * Signs of [[chronic kidney disease]] | ||
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* [[Normocytic anemia|Normocytic]] | |||
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* Low [[Erythropoietin|erythropoietin level]] | |||
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* [[Epoetin alfa]] 50-100 units/kg 3 times weekly | * [[Epoetin alfa]] 50-100 units/kg 3 times weekly | ||
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* [[Nutritional deficiency]] | * [[Nutritional deficiency]] | ||
* [[Crohn's disease|Crohn's disease of terminal ileum]] | * [[Crohn's disease|Crohn's disease of terminal ileum]] | ||
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* [[Numbness]] | * [[Numbness]] | ||
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* [[Tingling]] | * [[Tingling]] | ||
* [[Paresthesias]] | * [[Paresthesias]] | ||
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* [[Macrocytic anemia|Macrocytic]] | |||
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* Low vitamin B12 or folate level | |||
* [[Megaloblastic anemia]] with hypersegmented [[neutrophils]] | |||
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* [[Vitamin B12]] 1000mcg daily | * [[Vitamin B12]] 1000mcg daily | ||
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'''Table legend:''' [[HELLP]], hemolysis/elevated liver enzymes/low platelets; '''TTP''', | '''Table legend:''' [[HELLP]], hemolysis/elevated liver enzymes/low platelets; '''TTP''', thrombotic thrombocytopenic purpura; '''CLL''', [[chronic lymphocytic leukemia]] | ||
==References== | ==References== |
Revision as of 17:15, 5 October 2018
Hemolytic anemia Microchapters |
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Hemolytic anemia differential diagnosis On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shyam Patel [2]
Overview
The differential diagnosis for hemolytic anemia is broad and includes a variety of conditions that affect red blood cells. Nutritional deficiencies and thalassemias are important components of the differentiation. Certain laboratory tests and physical exam features can help to distinguish these conditions. The treatment of these conditions are quite different, so it is important to distinguish hemolytic anemia from other causes of anemia or other conditions that present similarly.
Differentiating Hemolytic anemia from other Diseases
Characterisitc/Parameter | Etiology | Physical examination | Mean corpuscular volume | Laboratory abnormalities | Treatment | Other associated abnormalities |
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Hemolytic anemia |
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Sideroblastic anemia |
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Anemia of chronic disease |
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Thalassemia |
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Iron deficiency anemia |
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Erythropoietin deficiency |
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Vitamin B12 or folate deficiency |
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Table legend: HELLP, hemolysis/elevated liver enzymes/low platelets; TTP, thrombotic thrombocytopenic purpura; CLL, chronic lymphocytic leukemia
References
- ↑ Platzbecker U, Symeonidis A, Oliva EN, Goede JS, Delforge M, Mayer J; et al. (2017). "A phase 3 randomized placebo-controlled trial of darbepoetin alfa in patients with anemia and lower-risk myelodysplastic syndromes". Leukemia. 31 (9): 1944–1950. doi:10.1038/leu.2017.192. PMC 5596208. PMID 28626220.