Lymph nodes & spleen, nonlymphoid
Spleen-other nonneoplastic disorders
Hemolytic anemia

Topic Completed: 1 October 2012

Minor changes: 4 July 2020

Copyright: 2003-2019,, Inc.

PubMed Search: Hemolytic anemia[TI] spleen[TIAB]

Page views in 2019: 2,234
Page views in 2020 to date: 1,331
Cite this page: Mansouri J. Hemolytic anemia. website. Accessed July 13th, 2020.
Definition / general
  • Congenital (hereditary spherocytosis, sickle cell) or acquired
  • Acquired cases are usually due to deposition of immune complexes on red blood cell membranes; also bacterial hemolysins, plasma lipid abnormalities, parasites
  • Immune related cases often due to brucellosis, Hodgkin lymphoma, leukemia, sarcoidosis, SLE (lupus), tuberculosis
  • Coombs test: detects acquired cases via detection of surface immune complexes; first wash patient's red blood cells, then add antihuman globulin rabbit serum, agglutination implies acquired hemolytic anemia
  • Direct Coombs test: detects antibody attached to red blood cells (above)
  • Indirect Coombs test: detects serum antibodies (i.e. antibodies NOT attached to red blood cells)
  • Steroids or immunosuppressives
  • Splenectomy if unresponsive
Gross description
  • Firm, deep red tissue, thin capsule, no grossly identifiable Malpighian follicles, 100 - 1000 g
Microscopic (histologic) description
  • Congestion in cords and sinuses, hemosiderin deposition, extramedullary hematopoiesis, erythrophagocytosis with neutrophils, reactive follicular hyperplasia
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