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Hemolytic Anemia

Hemolytic Anemia



Definition - Clinical signs  - hematological findings - Biochemical findings and 
 Causes of hemolytic  Anemia




DEFINITIONS
Hemolytic Anemia is defined as increase in the rate of destruction and removal of RBCs and ability of bone marrow to respond to anemia is unimpaired (erythropoietic hyperplasia of bone marrow ).

Clinical signs

- pale mucous membranes (anemiia)
- Jaundice 
- Hemoglobinuria 


hematological findings

- Anemia , decreased Hb concentration , RBC count and PCV .
- Typical findings of regenerative anemia such as , anisocytosis , polychromasia , reticulocytosis  and RBCs are macrocytic hypochromic  
- Increased MCV and decreased MCH and MCHC 
- leukocytosis  due to neutrophilia  with shift to left 
- Bone marrows shows normoblastic erythroid  hyperplasia with decreased M:E ratio ( myeloid : erythroid ratio ) indicating elevation of erythropioesis 


Biochemical findings


1 - Increased unconjugated  bilirubin 
2 - Plasma protein concentration  is normal 
3 - Hemoglobinemia 


 Causes of hemolytic  Anemia 

1 - Hereditary causes of hemolytic Anemia 
- Hemolytic anemia due to membrane defect such as hereditary spherocytosis . 
- Hemolytic anemia due to Hb defect , ( hemoglobino pathies) such as , thalassemia , sickle cell anemia . 
- Hemolytic anemia due to enzyme defect , such as pyruvate kinase deficiency and glucose-6 phosphate dehydrogenase deficiency 
- Congenital erythropoietic porphyria . 


2 - Acquired hemolytic anemia 
     
Causes  of  Acquired hemolytic anemia

a- Autoimmune hemolytic anemia in the tyoe of anemia red blood cells destruction is accelerated by auto antibody against mature erythrocytes . 
This type may be occure as a primary (idiopathic) disorder or secondary to other diseases such as bacteria , viral or protozoan infections . 
b- Hemolytic anemia associated with some chemicals and drugs 
Chemicals that can cause hemolytic anemia are lead , copper , phenothiazine , methylene blue, saponins  and naphthalene , in addition to certain drugs such as some sulfnilamides , acetanilid and nitrofurantion 

c- Hemolytic anemia caused by blood parasites such as anaplasmosis , babesiosis , trypanosomiasis , theileriasis and malaria in human 

d - Hemolytic anemia caused by bacterial infections such as staphylococcus & toxoplasma  infections in humans . 
e - Hemolytic anemia due to viral infections 
f - hemolytic anemia due to poisonous plants and venoms ( snake venom ) 
g - Mechanical causes such as trauma to RBCs caused by cardiac valve and DIC 

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