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Traumatic Hemolytic Anemia

Hemolysis due to Trauma


Presentation

  • TABLE 20–1 SEVERITY OF PROSTHETIC VALVE HEMOLYSIS View Table Favorite Table Download (.pdf) TABLE 20–1 SEVERITY OF PROSTHETIC VALVE HEMOLYSIS Mild Moderate Severe Hemosiderinuria Present Present Marked Hemoglobinuria Absent Absent Absent Schistocytosis[mhmedical.com]
  • Iron deficiency anemia occasionally is superimposed on the hemolysis as a result of chronic hemosiderinuria and, when present, responds to iron-replacement therapy. Resources In This Article[merckmanuals.com]
  • None of the patients presented with adverse reactions during the infusions or with severe infections as a result of immunosuppression.[learningcenter.ehaweb.org]
  • […] of Hemolytic Anemia The presentation of hemolytic anemia depends on the duration of the process as well as its severity.[medcaretips.com]
  • CLINICAL PRESENTATIONS The clinical manifestations of sickle cell disease vary from patient to patient and from region to region, even among those who have apparently similar phenotypes.[pedsinreview.aappublications.org]
HELLP Syndrome
  • […] secondary to other disorders such as sepsis, malignancy, pregnancy complications, trauma or surgery Stenotic or mechanical heart valves, or prosthetic valve dysfunction (ie. perivalvular leak) Hemolytic uremic syndrome or related disorders such as the HELLP[merckmanuals.com]
  • HELLP syndrome The patient should be admitted to the hospital and fetal monitoring should take place. Liver biopsy may be needed to differentiate a primary liver process if suspected.[oncologynurseadvisor.com]
  • The presence of preeclampsia, hemolysis, elevated liver enzymes, and low platelet counts is known as the HELLP syndrome. The HELLP syndrome can occur with minimal signs or symptoms of preeclampsia.[emjournal.net]
Family History of Anemia
  • Family history of anemia was negative. Her past history included the placement of an artificial aortic heart valve a number of years earlier. Her medications included warfarin (prothrombin time was well regulated) and a small dose of aspirin daily.[bloodjournal.org]
  • Patients should be asked about a family history of anemia or jaundice. Physicians should inquire if these symptoms have ever happened before and whether patients have recently started any new medications (4, 9).[emdocs.net]
Fishing
  • Meat, poultry, fish, and iron-fortified foods or dark leafy greens and certain beans are good sources of iron. Children and pregnant or nursing women especially need more iron due to increased requirements.[labtestsonline.org]
Generalized Lymphadenopathy
  • Persistent generalized lymphadenopathy' Group IV. Other disease Subgroup A Constitutional disease Subgroup B. Neurologic disease Subgroup C. Secondary infectious diseases Category C-1. ‏[books.google.com]
Systolic Murmur
  • She had a systolic murmur at the upper sternum with sounds typical of an implanted heart valve. There was no evidence of congestive heart failure. Her nails were normal and the spleen was not palpable.[bloodjournal.org]

Workup

  • Once hemolytic anemia is diagnosed, the next step in the workup is to differentiate extravascular from intravascular hemolysis. As mentioned above, splenomegaly is a physical finding that points strongly toward extravascular hemolysis.[thebigl.co]
  • Transfusions of platelets in TTP may make condition worse Urgent use of second and third line treatments in refractory TTP helps prevent complications Patients with DIC should first be stabilized, prior to workup or treatment of underlying causes.[oncologynurseadvisor.com]
  • However, recognizing that a hemolytic process is present is also very important, as this will guide workup and occasionally, specific treatments. References / Further Reading Kelton JG, Chan H, Heddle N, et al. Blood and Bone Marrow Pathology.[emdocs.net]

Treatment

  • Treatment Treatment is directed at the underlying cause. Iron loss can be remedied with iron replacement therapy for a period of time. References 1. Merck Manual (Home edition): Anemia 2.[nethealthbook.com]
  • […] as the HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count), and systemic sclerosis renal crisis Rare cases of significant repetitive impact, such as foot strike hemolysis (march hemoglobinuria), karate strikes, or hand drumming Treatment[merckmanuals.com]
  • Because she had no evidence of cardiovascular decompensation, the only treatment needed was iron replacement.[bloodjournal.org]
  • For severe anemia ineligible for reoperation, recombinant human erythropoietin treatment may diminish or eliminate transfusion requirements.[mhmedical.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

  • THERAPY, COURSE, AND PROGNOSIS If the anemia is sufficiently severe, the most effective treatment consists of replacement of the prosthesis.[medtextfree.wordpress.com]
  • […] the Rh locus Treatment: Steroids: induce remission in 2/3 of patients If disease refractory to steroid taper, can initiate steroid-sparing immunosuppression Splenectomy: equivalent efficacy to steroids IVIG: only occasionally effective (unlike in ITP) Prognosis[errolozdalga.com]
  • Prognosis of typical and atypical HUS is good with high survival rates with supportive treatment or eculizumab. Kidney function can return to normal when eculizumab is started early. This is the key to try to preserve kidney function.[oncologynurseadvisor.com]
  • Prognosis The prognosis, or outlook, of anemia is often good, depending upon the type and specific cause of the disorder. The severity of anemia, patient’s age, patient’s health, and patient’s compliance with treatment will affect recovery.[phlbi.org]
  • 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]

Etiology

  • ERSLEV Etiology and Pathogenesis Clinical Features Laboratory Features Differential Diagnosis Therapy, Course, and Prognosis Chapter References The abrasive effect on red cells of arteriosclerotic or stenotic cardiac valves is usually minimal, resulting[medtextfree.wordpress.com]
  • […] production and keep up with the loss. 1, 2, 3 Usually HAs are diagnosed through laboratory tests, however, the patient's history and physical examination are crucial as they provide important information about the presence of hemolysis and its probable etiology[ncbi.nlm.nih.gov]
  • Patients admitted to the ICU with different etiology showed symptoms and signs of microangiopathic hemolytic anemia. There were 80 patients (age: 20 - 70 years) and 100 controls in this study. Controls were selected at random from a laboratory.[thejh.org]
  • This possible mechanism should be considered in patients with iron deficiency anemia with no apparent etiology (gastrointestinal bleeding, heavy menses, pregnancy, or hookworm infestation).[thebigl.co]
  • The etiologies of hemolysis often are categorized as acquired or hereditary. Common acquired causes of hemolytic anemia are autoimmunity, microangiopathy, and infection.[aafp.org]

Epidemiology

  • Questions 14-17 For each epidemiologic concept listed below, select the term that most appropriately describes it. ‏ الصفحة 172 - Group I. Acute infection Group II. Asymptomatic infection' Group III. Persistent generalized lymphadenopathy' Group IV.[books.google.com]
  • EPIDEMIOLOGY The sickle gene is prevalent in West Africa, Central Africa, the Mediterranean, the Middle East, and certain parts of India.[pedsinreview.aappublications.org]
  • Epidemiology Risk factors are variable and depend on the underlying cause.[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • This disorder is similar to TTP and HUS in that endothelial cell damage plays a key role in the pathophysiology.[emdocs.net]
  • PATHOLOGY, PATHOPHYSIOLOGY, AND PATHOGENESIS In the sickle hemoglobin, a mutation in codon 6 of the beta chain (GAT8594’3fGGT) leads to replacement of glutamic acid by valine.[pedsinreview.aappublications.org]
  • Pregnancy 10 HUS: Hemolytic Uremic Syndrome  Multisystem Disorder  Onset between 6 months- 5 years  Triad of clinical findings Hemolytic anemia with RBC fragments Thrombocytopenia Acute nephropathy  Classifed based on presence or absence of diarrhea 11 Pathophysiology[slideplayer.com]
  • SLE), immune deficiency, liquid tumors, post-hematopoietic stem cell transplant Pathophysiology: IgG (and subsequently fixed complement) adhere to phagocytes, resulting in partial ingestion and creation of spherocytes, which are cleared by spleen Direct[errolozdalga.com]
  • Pathophysiology of Hemolytic Anemia Normal bone marrow is capable of increasing its production rate by about 6 to 8 times.[medcaretips.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]
  • Prevention A healthy lifestyle, including an appropriate diet, limited alcohol use, and regular medical checkups for blood tests can help to prevent anemia or, for those already diagnosed with the condition, keep it under control.[phlbi.org]
  • These data can provide a valuable tool for prevention and target management of these pathologies.[thejh.org]
  • […] immediately observed that patients in whose aorta a Hufnagel valve was inserted developed anemia.1 This anemia was shown to be caused by mechanical injury and fragmentation of red cells impacted at high speed on a foreign surface.2,3 Since then the prevention[medtextfree.wordpress.com]
  • HELLP Intravenous magnesium sulfate to prevent seizures and control hypertension should be started.[oncologynurseadvisor.com]

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