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Definition / general | Treatment | Gross description | Microscopic (histologic) descriptionCite this page: Mansouri J. Diagnosing hemolytic anemia. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/hematologyhemolyticanemia.html. Accessed April 19th, 2024.
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)
Treatment
- 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
