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Toxic Hemolytic Anemia

Non Autoimmune Toxic Hemolytic Anemia


Presentation

  • They presented three cases in adults. Shortly thereafter Kohn 2 and Willis 3 each presented a case in an infant. Wood 4 studied 522 patients, 144 children and 378 adults, receiving sulfanilamide and found that 21 developed acute anemia.[annals.org]
  • Essential examination, diagnostic, and treatment information for each body system is presented in a logical format so you can quickly find answers during equine emergencies.[books.google.de]
  • Microangiopathic hemolytic anemia - most often present with schistocytes (RBC fragments) but may have spherocytes as well.[pedclerk.bsd.uchicago.edu]
  • If hemolytic anemia is present, there will be a higher number of young red blood cells than normal.[diagnose-me.com]
Anemia
  • Research of Toxic Hemolytic Anemia has been linked to Anemia, Anemia, Hemolytic, Poisoning, Pregnancy Complications, Hematologic, Hemolysis (disorder).[novusbio.com]
  • Most often, with toxic anemia, intravascular hemolysis is observed. Hemolytic anemia can also occur with infectious diseases.[m.iliveok.com]
  • Wood 4 studied 522 patients, 144 children and 378 adults, receiving sulfanilamide and found that 21 developed acute anemia. Of these, 12 or 8.3 per cent were children, and nine or 2.4 per cent were adults.[annals.org]
  • anemia, traumatic cardiac Infective hemolytic anemia Mechanical hemolytic anemia Microangiopathic hemolytic anemia Polyagglutinable erythrocyte syndrome Toxic hemolytic anemia Traumatic cardiac hemolytic anemia Applies To Hemolytic anemia: mechanical[icd9data.com]
  • Mechanical hemolytic anemia Microangiopathic hemolytic anemia Toxic hemolytic anemia MS-DRG Mapping DRG Group #793 - Full term neonate with major problems.[icd.codes]
Anemia
  • Research of Toxic Hemolytic Anemia has been linked to Anemia, Anemia, Hemolytic, Poisoning, Pregnancy Complications, Hematologic, Hemolysis (disorder).[novusbio.com]
  • Most often, with toxic anemia, intravascular hemolysis is observed. Hemolytic anemia can also occur with infectious diseases.[m.iliveok.com]
  • Wood 4 studied 522 patients, 144 children and 378 adults, receiving sulfanilamide and found that 21 developed acute anemia. Of these, 12 or 8.3 per cent were children, and nine or 2.4 per cent were adults.[annals.org]
  • anemia, traumatic cardiac Infective hemolytic anemia Mechanical hemolytic anemia Microangiopathic hemolytic anemia Polyagglutinable erythrocyte syndrome Toxic hemolytic anemia Traumatic cardiac hemolytic anemia Applies To Hemolytic anemia: mechanical[icd9data.com]
  • Mechanical hemolytic anemia Microangiopathic hemolytic anemia Toxic hemolytic anemia MS-DRG Mapping DRG Group #793 - Full term neonate with major problems.[icd.codes]
Fever
  • Symptoms such as fever are prominent among infections such as malaria, babesiosis, C. perfringens and B. bacilliformis (Oroya fever). Diarrhea that preceded or is concurrent with hemolytic anemia may be suggestive E. coli or Shigella associated HUS.[clinicaladvisor.com]
  • Severe hemolytic anemia can cause chills, fever, pain in the back and abdomen, or shock.[nhlbi.nih.gov]
  • Although, this patients emesis was probably due to the toxic levels of Pyridium, patients on long term therapeutic treatment have shown symptoms of hypersensitivity hepatitis with nausea, vomiting, epigastric or right upper quadrant pain, myalgias, fever[path.upmc.edu]
  • Hemolytic crisis (acute, severe hemolysis) is uncommon; it may be accompanied by chills, fever, pain in the back and abdomen, prostration, and shock. Hemoglobinuria causes red or reddish-brown urine.[merckmanuals.com]
  • 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]
Pallor
  • Clinical presentation of hemolytic anemia: There is pallor of the mucous membrane which can be judged from the tongue. There is fluctuating of jaundice. In some patients, bilirubin will very high and may need blood transfusion exchange.[labpedia.net]
  • Symptoms and Signs Systemic manifestations of hemolytic anemias resemble those of other anemias and include pallor, fatigue, dizziness, and possible hypotension. Scleral icterus and/or jaundice may occur, and the spleen may enlarge.[merckmanuals.com]
  • 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]
  • It presents as an acute illness manifesting with sudden onset of pallor, hemoglobinuria, icterus, and hepatosplenomegaly during the convalescent stage.[clinicaladvisor.com]
Hyperthermia
  • […] addition to acute intravascular hemolysis (DVS-syndrome), gyrometry syndrome includes: gastrointestinal symptoms, manifested in the first 6-24 hours after poisoning and lasting from 1 to 3 days; neurologic syndrome with asthenia and a sharp headache; hyperthermia[m.iliveok.com]
Jaundice
  • Two months later he was referred to the Emergency Room due to worsening of his general health, floating in the right hip and mucocutaneous jaundice. Laboratory tests suggested autoimmune hemolytic anemia.[unboundmedicine.com]
  • Spherocytic anemia or ‘familial hemolytic jaundice’ is a hereditary disorder in which the red cells are shaped like spheres instead of being doughnut-shaped (toroidal). Jaundice results from excessive destruction of the abnormal cells by the spleen.[innvista.com]
  • , spleen and liver enlargement Clinical manifestations of hemolytic anemia Increased destruction of red blood cells caused by elevation in Bilirubin levels In hemolytic anemia Jaundice is due to Hyperactivity Spleen and liver enlarge due to Maintaining[quizlet.com]
  • The urine may become deep orange-red in color due to the dye properties of the drug, which can also mask colored urine of hemolytic jaundice. The hemolytic anemia in these patients may occur with and without Glucose 6-Phosphate deficiency.[path.upmc.edu]
Scleral Icterus
  • Scleral icterus and/or jaundice may occur, and the spleen may enlarge. Hemolytic crisis (acute, severe hemolysis) is uncommon; it may be accompanied by chills, fever, pain in the back and abdomen, prostration, and shock.[merckmanuals.com]
  • Also check for jaundice, or scleral icterus. Cervical, axillary and inguinal lymphadenopathy may be present. Lymphadenopathy may be prominent features in EBV, and HIV infections.[clinicaladvisor.com]
Tachycardia
  • Some additional signs and symptoms of naphthalene ingestion include headache, profuse sweating, tachycardia, respiratory distress, listlessness, confusion.[flipper.diff.org]
Fracture
  • Extensive washing was carried out and the fractured ceramic 'insert' was replaced for a polyethylene 'insert'.[unboundmedicine.com]
Anuria
  • In acute toxic hemolytic anemia, intravascular hemolysis arises, manifested by hemoglobinemia, hemoglobinuria, and sometimes accompanied by collapse and anuria.[m.iliveok.com]
  • While our patient’s prolonged VPA level elevation above 130 μg/ml are consistent with these studies, the microangiopathic hemolytic anemia, anuria, and acute kidney injury reflect a more severe hematologic etiology, consistent with thrombotic microangiopathy[bmcnephrol.biomedcentral.com]
Kidney Failure
  • In addition, the patient needs emergency post-dandruff therapy (treatment of kidney failure, hepatitis, neurological syndrome).[m.iliveok.com]
  • If anemia is caused by kidney failure, however, then it most likely will require long-term monitoring and treatment. In general, young people recover from anemia more quickly than older people do.[emedicinehealth.com]
Headache
  • In addition to acute intravascular hemolysis (DVS-syndrome), gyrometry syndrome includes: gastrointestinal symptoms, manifested in the first 6-24 hours after poisoning and lasting from 1 to 3 days; neurologic syndrome with asthenia and a sharp headache[m.iliveok.com]
  • You may be short of breath or have a headache. Your doctor will diagnose anemia with a physical exam and blood tests. Treatment depends on the kind of anemia you have.[icdlist.com]
  • Signs and symptoms may include fatigue, dizziness, heart palpitations, pale skin, headache, confusion, jaundice, and a spleen or liver that is larger than normal.[nhlbi.nih.gov]
  • Some additional signs and symptoms of naphthalene ingestion include headache, profuse sweating, tachycardia, respiratory distress, listlessness, confusion.[flipper.diff.org]
  • Attacks are precipated on exposure to cold and assoc with hemoglobinemia, hemoglobinuria, chills and fever, back, leg and abdominal pain, headache and malaise. 42. TREATMENT. Maintain patient in warm environment. Splenectomy not of value.[slideshare.net]
Asthenia
  • In addition to acute intravascular hemolysis (DVS-syndrome), gyrometry syndrome includes: gastrointestinal symptoms, manifested in the first 6-24 hours after poisoning and lasting from 1 to 3 days; neurologic syndrome with asthenia and a sharp headache[m.iliveok.com]

Workup

  • An array of laboratory tests are available for detecting hemolysis, and specialized tests may be indicated to diagnose the cause for hemolysis (see Workup ).[emedicine.medscape.com]
Heinz Bodies
  • Red cells may contain Heinz bodies and the cells may be fragmented showing anisocytosis and poikilocytosis. Serum bilirubin is elevated.[flipper.diff.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]
Lactate Dehydrogenase Increased
  • DISCUSSION The initial symptoms and laboratory findings of hemolytic anemia, depressed hemoglobin and haptoglobin concentrations, increased lactate dehydrogenase, increased indirect bilirubin, and an IgG-positive result in a direct antiglobulin test were[clinchem.aaccjnls.org]
Reticulocytes Increased
  • Parameters Hemolytic anemia Hb Decreased 6 to 10 g/dL Reticulocytes Increased 5 to 20% MCV Normal or mild increase MCHC Increased Bone marrow Erythroid hyperplasia Coombs test Direct is negative RDW Increased Possible References Used Back to tests[labpedia.net]
Clostridium Perfringens
  • perfringens, alpha- or beta-hemolytic streptococci, meningococci), by invasion and destruction of the RBC by the organism (eg, Plasmodium species, Bartonella species), or by antibody production (eg, Epstein-Barr virus, mycoplasma).[merckmanuals.com]
  • Clostridium perfringens (C. perfringens) causes toxin mediated destruction of red blood cells. B. Describe a diagnostic approach/method to the patient with this problem. Figure 1 gives a good outline for how to approach these patients.[clinicaladvisor.com]
Plasmodium Falciparum
  • falciparum Hemolytic anemia with infection Hemolytic anemia, babesiosis Hemolytic anemia, microangiopathic Hemolytic anemia, P falciparum Hemolytic anemia, traumatic cardiac Infective hemolytic anemia Mechanical hemolytic anemia Microangiopathic hemolytic[icd9data.com]
  • falciparum Hemolytic anemia with infection Hemolytic anemia, babesiosis Hemolytic anemia, microangiopathic Hemolytic anemia, nonautoimmune Hemolytic anemia, p falciparum Hemolytic anemia, traumatic cardiac Microangiopathic hemolytic anemia Non-autoimmune[icd10data.com]

Treatment

  • What to Do and What Not to Do boxes guide you through the step-by-step treatment of an emergency and draw your attention to important steps to take and those to avoid.[books.google.de]
  • Treatment of toxic hemolytic anemia Treatment of toxic hemolytic anemia consists in stopping contact with the toxic agent or in eliminating it (including if possible with the help of an appropriate antidote), and for infectious diseases - in adequate[m.iliveok.com]
  • Treatments may include lifestyle changes, medicines, blood transfusions, blood and bone marrow transplants, or surgery to remove the spleen.[nhlbi.nih.gov]
  • A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions.[leehealth.org]

Prognosis

  • Prognosis The prognosis for patients with hemolytic anemia depends on the underlying cause. Overall, mortality rates are low in hemolytic anemias. However, the risk is greater in older patients and patients with cardiovascular impairment.[emedicine.medscape.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]
  • Prognosis AIHA is transient in children following viral infection. Usually chronic in adults with exacerbations and remissions 27. Warm AIHA 28. COLD ANTIBODY IMMUNOHEMOLYTIC ANEMIA.[slideshare.net]
  • Anemia Prognosis How well someone with anemia will recover depends on the cause of the anemia and how severe it is.[emedicinehealth.com]

Etiology

  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • Abstract INTRODUCTION Hemolytic anemia may be associated with multiple etiologies, including toxic substances, such as metals, which is a rare cause.[unboundmedicine.com]
  • INTRODUCTION: Hemolytic anemia may be associated with multiple etiologies, including toxic substances, such as metals, which is a rare cause.[ncbi.nlm.nih.gov]
  • A dual etiology is responsible: direct toxicity of VPA on bone marrow and VPA’s inclusion with and modification of the platelet membrane [ 4 ]. Acute TMA in conjunction with VPA toxicity has, to our knowledge, not been reported.[bmcnephrol.biomedcentral.com]
  • Hemolytic anemia has multiple causes, and the clinical presentation can differ depending on the etiology.[emedicine.medscape.com]

Epidemiology

  • Epidemiology AIHA is a relatively rare disorder in children and is most often seen after a recent viral illness.[pedclerk.bsd.uchicago.edu]
  • These questions should be focused on three main areas: High risk behavior or exposures, Local infectious disease epidemiology, Travel to areas that are endemic for specific infectious pathogens.[clinicaladvisor.com]
  • Epidemiology Hemolytic anemia represents approximately 5% of all anemias. Acute AIHA is relatively rare, with an incidence of one to three cases per 100,000 population per year. [27] Hemolytic anemias are not specific to any race.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • Defining the pathophysiologic mechanism of the hemolysis is important for guiding the differential diagnosis. I.[clinicaladvisor.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]
  • Pathophysiology of pediatric multiple organ dysfunction syndrome. Pediatr Crit Care Med. 2017;18:3. Google Scholar Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, Janecek E, Domecq C, Greenblatt DJ.[bmcnephrol.biomedcentral.com]
  • Pathophysiology Hemolysis can be due to hereditary and acquired disorders. [1, 2] The etiology of premature erythrocyte destruction is diverse and can be due to conditions such as intrinsic membrane defects, abnormal hemoglobins, erythrocyte enzymatic[emedicine.medscape.com]

Prevention

  • Causes include RBC membrane abnormalities such as bound immunoglobulin, or physical abnormalities restricting RBC deformability that prevent egress from the spleen. Extravascular hemolysis is characterized by spherocytes.[med-ed.virginia.edu]
  • Anemia Prevention Some common forms of anemia are most easily prevented by eating a healthy diet and limiting alcohol use. Many types of anemia can be avoided by seeing a doctor regularly to check blood tests and when problems arise.[emedicinehealth.com]
  • In order to prevent infectious diseases through vaccination, it is important to identify specific antigens which often exist in the cell membrane and capsule and also become the centre of host-pathogen interactions.[mbiotech.org]
  • Acute, fulminating hemolytic anemic crisis is treated with fluid and electrolyte replacement to prevent shock and renal damage from clogging the kidney tubules by red cell debris. Transfusions of blood products are sometimes given.[innvista.com]
  • Management of TTP/HUS must be initiated emergently if this diagnosis is suspected to prevent adverse outcomes. Treatment of TTP/HUS involves plasma exchange. Avoid platelet transfusions as this may lead to exacerbation of symptoms.[clinicaladvisor.com]

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