haemolytic anaemia

Question 1

name the two possible mechanisms for haemolytic anaemia to occur?

Answer 1

• intravascular
  ( prosthetic heart valves, G6PD, TTP, DIC)
• extrinsic
  ( due to defective RBCs, removed by phagocytes) most common

Question 2

What are the causes of haemolytic anaemia?

Answer 2

- Genetic: 
> spherocytosis 
> sickle cell 
> thalassaemia 
> G6PD 
- Haemolytic disease of the newborn
- Blood transfusion reaction 
- SLE 
- Lymphoma 
- Leukaemia 
- HUS/ TTP 
- Infection, Drug related

Question 3

how might this person present?

Answer 3

• fatigue, SOB
• dark urine (haemoglobinuria)
• jaundiced (due to breakdown)
• splenomegaly
• bleeding/ bruising

Question 4

What investigations would you do?

Answer 4

• FBC, U+Es, LFTs
• coagulation
• blood film
• Coombs test
• Hb electrophoresis
• US for spleen
• CXR
• ECG

Question 5

how might you manage haemolytic anaemia?

Answer 5

• folic acid and iron therapy
• stop any medications causing it
• transfusion
• splenectomy

Question 6

what kind of complications may arise as a result?

Answer 6

• Cardiac failure (due to anaemia)

- Jaundice