Normocytic Hemolytic Anemia Causes
- Hereditary Spherocytosis
- RBC Enzyme Deficiency
- Hemoglobin C Defect
- Paroxysmal Nocturnal Hemoglobinuria (PNH)
- Sickle Cell Anemia
- Autoimmune
- Microangiopathic
- Mechanical Destruction
- Prosthetic Cardiac Valves
- Infection
- Snake Venom
Warm Agglutinin Autoimmune Hemolytic Anemia (W-AIHA)
- Most Common Autoimmune Hemolytic Anemia
- IgG Coats RBCs at Warm Temperatures
- Fc Portion of IgG Recognized By Macrophages
- Extravascular Hemolysis
- Medications
- Alpha Methyldopa
- Chronic Lymphocytic Leukemia (CLL)
- Systemic Lupus Erythematosus (SLE)
- Positive Coombs Test
- Corticosteroids
- Splenectomy
- Intravenous Immunoglobulin (IVIG)
- Rituximab
Cold Agglutinin Autoimmune Hemolytic Anemia (C-AIHA)
- IgM Binds to RBCs at Cold Temperatures (28-31C)
- Extravascular Hemolysis
- Waldenstrom's Macroglobulinemia
- Mycoplasma Pneumoniae
- Infectious Mononucleosis
- Lymphomas and CLL
- Acrocyanosis with Cold Exposure
- Blue Fingers and Toes
- Positive Coombs Test
- Avoid Cold
- Rituximab
- +/- Fludarabine
Disseminated Intravascular Coagulation (DIC)
- Bleeding State
- Activation of Clotting Factors
- Deficiency of Clotting Factors
- Sepsis
- Trauma
- Obstetric Complications
- Acute Pancreatitis
- Malignancy
- Nephrotic Syndrome
- Transfusion
Thrombotic Thrombocytopenic Purpura (TTP)
- Inhibition or deficiency of ADAMTS 13
- vWF Multimers are Not Degraded
- Microthrombi (and Emboli)
- FAT RN Pentad
- Fever
- Anemia
- Thrombocytopenia
- Renal Dysfunction
- Neurologic Abnormalities (Altered Mental status)
- Plasmapheresis
- Corticosteroids
- Splenectomy
Hemolytic Uremic Syndrome (HUS)
- Children
- Preceded by Acute Diarrheal Illness
- Endothelial Damage
- Microangiopathic Hemolytic Anemia (MAHA)
- Thrombocytopenia
- Renal Failure
- Helmet cells
- LDH
- Dialysis
- Supportive
Severe Preeclampsia
- Vasospasm and Decreased Organ Perfusion
- Intravascular Coagulation
- Increased Permeability and Capillary Leakage
- Hypertension
- Proteinuria or End-Organ Dysfunction
- Hepatic Dysfunction and Hemolysis
- Elevated Liver Enzymes
- Low Platelet Counts
WBC Differential Lab Value
- White Blood Cells (WBC)
- 5-10 (5,000-10,000)
- Neutrophils (50%-70%)
- Bands (2%-5%)
- Segs (50%-70%)
- Lymphocytes (20%-40%)
- Monocytes (4%-8%)
- Eosinophils (2%-4%)
- Basophils (0.5%-1.5%)
Severe Combined Immunodeficiency (SCID)
- Both B and T Cell Deficiency
- Recurrent Viral, Bacterial, Fungal, Protozoal Infections
- Defective Interleukin (IL) 2 Receptor
- X-Linked
- Adenosine Deaminase Deficiency
- Failure to Synthesize MHC II Antigens
- Treat with Bone Marrow Transplant
Febrile Neutropenia
- Oncologic Emergency
- Fever
- Absolute Neutrophil Count < 500/µL
- Increased Risk of Infection
- Blood Cultures
- Broad Spectrum Antibiotics