Hematology & immune disorders

Hemolytic anemia

Diagnosing hemolytic anemia

Last author update: 1 October 2012
Last staff update: 15 July 2022

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

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Cite this page: Mansouri J. Diagnosing hemolytic anemia. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/hematologyhemolyticanemia.html. Accessed September 27th, 2023.
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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