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Nonimmune Hemolysis

Non Immune Hemolysis


Presentation

  • It is not uncommon to find that an individual who once had an anti-Jk a to have no serologically demonstrable antibody present in serum a few months after the antibody was originally identified. 11 This may explain why both donors of the cases presented[nature.com]
  • Glucose-6 Phosphate Dehydrogenase Deficiency in A Geriatric Patient The Editor, Sir, An otherwise healthy 76 years old female patient presented to emergency department with acute fatigue, weakness and jaundice.[mona.uwi.edu]
  • Kellerman present the expertise and knowledge of hundreds of skilled international leaders on evidence-based clinical management options, ensuring you're well equipped with the practical and accurate guidance needed for effective patient care.[books.google.com]
Hunting
  • Anti-Jk b identified in Jk b positive recipient following T cell depleted bone marrow transplant Transfusion 1987 27 : 525 (Abstr.) 7 Myser T, Steedman M, Hunt K et al.[nature.com]
Palpitations
  • With new chapters on palpitations, hypokalemia and hyperkalemia, vision rehabilitation and more, you can stay on top of current treatment practices.[books.google.com]
Dry Eyes
  • Brand-new chapters cover Ebola, Chikungunya, dry eye, and adolescent health. In addition to current therapy, each chapter also features important diagnostic criteria to ensure delivery of the correct diagnosis and treatment.[books.google.com]
Dark Urine
  • The macrophages then proceed in destroying the “tagged” RBCs producing the typical hemolytic by-products which cause some of the clinically relevant signs such as dark urine and jaundiced skin.[pedclerk.bsd.uchicago.edu]
  • Symptoms may include any of the following: Dark urine Fatigue Pale skin color Rapid heart rate Shortness of breath Yellow skin and whites of the eyes ( jaundice ) Stopping the drug that is causing the problem may relieve or control the symptoms.[medlineplus.gov]
  • This is a severe life threatening condition, the clinical features are : sudden onset of pallor, jaundice and dark urine. The cornerstone of diagnosis is a positive Coomb’s antiglobulin test in the presence of hemolysis.[link.springer.com]
  • Symptoms Symptoms may include any of the following: Dark urine Fatigue Pale skin color Rapid heart rate Shortness of breath Yellow skin and whites of the eyes ( jaundice ) Exams and Tests A physical exam may show an enlarged spleen.[ufhealth.org]

Workup

  • Hemolytic Anemia Workup. Medscape Reference. Available online at . Accessed October 2015. (March 21, 2014) National Heart, Lung and Blood Institute. Types of Hemolytic Anemia. Available online at . Accessed October 2015.[labtestsonline.it]
  • After an extensive workup, his pancytopenia was attributed to marrow suppression by anti-seizure medications, however, an explanation for his low haptoglobin was not identified.[omicsonline.org]
Normocytic Normochromic Anemia
  • Signs and Symptoms Pallor Jaundice Lethargy Abdominal pain Low-grade fever Dark urine (sever hemolysis) Hepatosplenomegaly Diagnostic tests CBC with smear Normocytic, normochromic anemia Reticulocytosis (or rare reticulocytopenia) Spherocytes, schistocytes[pedclerk.bsd.uchicago.edu]
Philadelphia Chromosome Positive
  • Case 1 The first patient was a 37-year-old white male with Philadelphia chromosome positive chronic myelogenous leukemia who presented with a WBC of 31 000. He was managed with hydroxyurea with adequate control for 2 years.[nature.com]

Treatment

  • Offer a full range of treatment options through coverage of the latest information on recently approved and soon-to-be approved drugs.[books.google.com]
  • ALWAYS need to rule out immune causes of hemolysis Lysed red cells may cause hemodynamic, renal and pulmonary problems, possibly death Clinical features Clinical features and treatment are similar to acute hemolytic transfusion reaction Stop transfusion[pathologyoutlines.com]
  • Despite B cells returning to normal 11 months after treatment, infant no 1 remained in clinical remission during follow-up (22 months post treatment).[learningcenter.ehaweb.org]

Prognosis

  • Counseling Long term prognosis depends on underlying cause and severity of the heart failure.[perinatology.com]
  • Outlook (Prognosis) The outcome is good for most people if they stop taking the drug that is causing the problem. Possible Complications Death caused by severe anemia is rare.[ufhealth.org]
  • […] features Pallor, fatigue, weakness Cyanosis of the extremities ( acrocyanosis ) Diagnosis Signs of hemolysis Peripheral blood smear : spherocytes, polychromasia Coombs test : positive Cold agglutinins titer C3 and C4 ; (due to complement activation) Prognosis[amboss.com]
  • The majority of cases are acute and carry a better prognosis with the possibility of spontaneous resolution within 6 months. The remaining cases are chronic and typically more difficult to treat.[pedclerk.bsd.uchicago.edu]

Etiology

  • Enzyme defects Glucose-6-phosphate dehydrogenase deficiency Pyruvate kinase deficiency Pathophysiology : autosomal recessive defect of pyruvate kinase Etiology : : Glucose is the only energy source for RBCs.[amboss.com]
  • After CAD is established, patients should be evaluated for infections, underlying malignancies and autoimmune disease, with greater than 70% of the cases attributable to these etiologies.[clinicaladvisor.com]
  • The etiologies of hemolysis often are categorized as acquired or hereditary. Common acquired causes of hemolytic anemia are autoimmunity, microangiopathy, and infection.[aafp.org]
  • We therefore performed a small prospective study of serial haptoglobin levels in patients undergoing IVC filter placement at our institution to determine whether IVC filters might be a non-immune etiology for low haptoglobin in some patients.[omicsonline.org]

Epidemiology

  • Epidemiology Risk factors are variable and depend on the underlying cause.[patient.info]
  • Epidemiology AIHA is a relatively rare disorder in children and is most often seen after a recent viral illness.[pedclerk.bsd.uchicago.edu]
  • (Review article outlining the epidemiology, pathogenesis, diagnostic and treatment of cold agglutinin disease. Highly informative explaining the major differences in pathogenesis and treatment between wAIHA and CAD.) Barcellini, W.[clinicaladvisor.com]
Sex distribution
Age distribution

Pathophysiology

  • Enzyme defects Glucose-6-phosphate dehydrogenase deficiency Pyruvate kinase deficiency Pathophysiology : autosomal recessive defect of pyruvate kinase Etiology : : Glucose is the only energy source for RBCs.[amboss.com]
  • Paroxysmal Nocturnal Hemoglobinuria (PNH) Discuss the molecular and pathophysiologic defects in paroxysmal nocturnal hemoglobinuria (PNH) and explain the test used to diagnose this disorder. List complications of PNH.[hematology.org]
  • Pathophysiology: Extravascular Versus Intravascular Hemolysis HA may be defined as increased destruction of red blood cells (RBCs). RBCs are cleared from the circulation via extravascular or intravascular mechanisms (Figure).[pedsinreview.aappublications.org]
  • Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Hemolytic anemia (HA) is characterized by increased red cell destruction and a decreased red cell life span.[mayomedicallaboratories.com]
  • Pathophysiology and Primary AIHA In AIHA the hemolysis is mainly extravascular, with sequestration mainly occurring in the liver and the spleen.[pedclerk.bsd.uchicago.edu]

Prevention

  • (ChemotherapyAdvisor) – Several studies demonstrate the role of aspirin in cancer prevention, according to the authors of a recently published review article.[cancertherapyadvisor.com]
  • Cyclosporine, used to prevent GVHD, has been associated with this type of hemolysis.[www3.mdanderson.org]
  • Prevention Avoid the drug that caused this condition. Images References Kumar V, Abbas AK, Aster JC. Red blood cell and bleeding disorders. In: Kumar V, Abbas AK, Aster JC, eds. Robbins and Cotran Pathologic Basis of Disease. 9th ed.[ufhealth.org]
  • Prevention Avoid the drug that caused this condition. References Kumar V, Abbas AK, Aster JC. Red blood cell and bleeding disorders. In: Kumar V, Abbas AK, Aster JC, eds. Robbins and Cotran Pathologic Basis of Disease. 9th ed.[mountsinai.org]
  • To prevent complications resulting from hemolysis of these remaining units, therefore, the decision was made to perform a red cell exchange.[nature.com]

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