Other nonneoplastic disorders
Hemolytic anemia

Author: Jaleh Mansouri, M.D. (see Authors page)

Revised: 2 March 2018, last major update October 2012

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

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

Cite this page: Mansouri, J. Hemolytic anemia. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/spleenhemolyticanemia.html. Accessed July 17th, 2018.
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