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Hemolytic Anemia

A. Inherited disorders

1. Defects in globin structure & syntheses: Sickle's cell, Thalassemia
2. Defects in the erythrocyte membrane
   Hereditary spherocytosis or eliptocytosis
3. Deficiency of RBC glycolytic enzymes: pyruvate kinase, hexokinase
4. Abnormality of RBC nucleotide metabolism
   Pyrimidine 5'nucleotidase deficiency, adenosine deaminase excess
5. Deficiency of enzyme: G6PD (glucose-6-phosphate dehydrogenase deficiency), glutamyl cysteine synthetase

B. Acquired disorders

1. Immunohemolytic anemias
   a. Secondary to transfusion of incompatible blood
   b. Hemolytic anemia of the newborn
   c. Due to warm reactive antibodies:
   (1) Idiopathic. (2) Secondary: virus & mycoplasma, lymphosarcoma & CLL, other malignancies, immune deficiency states, SLE & other autoimmune disorders. (3) Drug induced
   d. Due to cold reactive antibodies:
   (1) Cold hemagglutinin disease, paroxysmal cold hemoglobinuria
   
2. Traumatic & microangiopathic hemolytic anemia
   a. Prosthetic valves & other cardiac abnormalities
   b. HEMOLYTIC-UREMIC-SYNDROME
   c. TTP (Thrombotic thrombocytopenic purpura)
   d. Disseminated intravascular coagulation
   e. Graft rejection
   f. Immune complex disease
   
3. Infectious agents
   a. Protozoan: malaria, toxoplasmosis, leishmaniases, trypanosomiasis
   b. Bacteria: bartonellosis, clostridium, typhoid fever
   
4. Chemicals, drugs & venons
   a. Oxidant drugs & chemicals: napthalene, nitrofurantoin, sulfa drugs
   b. Non osidant chemicals: arsine, copper, water, venoms, associated with hemodialysis & uremia
   
5. Physical agents: thermal injury, ?ionizing radiation
   
6. Misc: paroxysmal nocturnal hemoglobinuria, hypophosphatemia, "Spur cell" anemia in liver disease, vit.E deficiency in newborn
   a. Protozoan: malaria, toxoplasmosis, leishmaniases, trypanosomiasis
   b. Bacteria: bartonel

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