Acquired hemolytic anemia
Encyclopedia
Acquired hemolytic anemia can be divided into immune and non-immune mediated forms of hemolytic anemia
.
is positive)
is negative)
A total of four mechanisms are usually described, but there is some evidence that these mechanisms may overlap.
Hemolytic anemia
Hemolytic anemia is a form of anemia due to hemolysis, the abnormal breakdown of red blood cells , either in the blood vessels or elsewhere in the human body . It has numerous possible causes, ranging from relatively harmless to life-threatening...
.
Immune
Immune mediated hemolytic anemia (direct Coombs testCoombs test
Coombs test refers to two clinical blood tests used in immunohematology and immunology...
is positive)
- Autoimmune hemolytic anemiaAutoimmune hemolytic anemiaAutoimmune hemolytic anemia occurs when antibodies directed against the person's own red blood cells cause the RBCs to burst , leading to insufficient plasma concentration. The lifetime of the RBCs is reduced from the normal 100–120 days to just a few days in serious cases...
- Warm antibody autoimmune hemolytic anemia
- Idiopathic
- Systemic lupus erythematosusSystemic lupus erythematosusSystemic lupus erythematosus , often abbreviated to SLE or lupus, is a systemic autoimmune disease that can affect any part of the body. As occurs in other autoimmune diseases, the immune system attacks the body's cells and tissue, resulting in inflammation and tissue damage...
(SLE) - Evans' syndrome (antiplatelet antibodies and hemolytic antibodies)
- Cold antibody autoimmune hemolytic anemia
- Idiopathic cold hemagglutinin syndrome
- Infectious mononucleosisInfectious mononucleosisInfectious mononucleosis is an infectious, widespread viral...
and mycoplasma (atypical) pneumonia - Paroxysmal cold hemoglobinuriaParoxysmal cold hemoglobinuriaParoxysmal cold hemoglobinuria is a disease of humans that is characterized by the sudden presence of hemoglobin in the urine , typically after exposure to cold temperatures....
(rare)
- Warm antibody autoimmune hemolytic anemia
- Alloimmune hemolytic anemia
- Hemolytic disease of the newbornHemolytic disease of the newbornHemolytic disease of the newborn, also known as hemolytic disease of the fetus and newborn, HDN, HDFN, or erythroblastosis fetalis, is an alloimmune condition that develops in a fetus, when the IgG molecules produced by the mother pass through the placenta...
(HDN)- Rh diseaseRh diseaseRh disease is one of the causes of hemolytic disease of the newborn...
(Rh D) - ABO hemolytic disease of the newborn
- Anti-Kell hemolytic disease of the newborn
- Rhesus c hemolytic disease of the newborn
- Rhesus E hemolytic disease of the newbornHemolytic disease of the newborn (anti-RhE)Hemolytic disease of the newborn is caused by the anti-RhE antibody of the Rhesus blood group system. The anti-RhE antibody can be naturally occurring, or arise following immune sensitization after a blood transfusion or pregnancy....
- Other blood groupBlood typeA blood type is a classification of blood based on the presence or absence of inherited antigenic substances on the surface of red blood cells . These antigens may be proteins, carbohydrates, glycoproteins, or glycolipids, depending on the blood group system...
incompatibility (RhC, Rhe, KiddKidd antigen systemThe Kidd antigen system is present on the membranes of red blood cells and the kidney and helps determine a person's blood type. The Jk antigen is found on a protein responsible for urea transport in the red blood cells and the kidney. The gene encoding this protein is found on chromosome 18....
, DuffyDuffy antigenDuffy antigen/chemokine receptor also known as Fy glycoprotein or CD234 is a protein that in humans is encoded by the DARC gene....
, MN, P and others)
- Rh disease
- Alloimmune hemolytic blood transfusion reactions (i.e. from a non-compatible blood typeBlood typeA blood type is a classification of blood based on the presence or absence of inherited antigenic substances on the surface of red blood cells . These antigens may be proteins, carbohydrates, glycoproteins, or glycolipids, depending on the blood group system...
)
- Hemolytic disease of the newborn
- Drug induced immune mediated hemolytic anemia
- PenicillinPenicillinPenicillin is a group of antibiotics derived from Penicillium fungi. They include penicillin G, procaine penicillin, benzathine penicillin, and penicillin V....
(high dose) - MethyldopaMethyldopaMethyldopa is an alpha-adrenergic agonist psychoactive drug used as a sympatholytic or antihypertensive. Its use is now mostly deprecated following the introduction of alternative safer classes of agents...
- Penicillin
Non-immune
Non-immune mediated hemolytic anemia (direct Coombs testCoombs test
Coombs test refers to two clinical blood tests used in immunohematology and immunology...
is negative)
- DrugsMedicationA pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...
(i.e., some drugs and other ingested substances lead to hemolysis by direct action on RBCs, e.g. ribavirinRibavirinRibavirin is an anti-viral drug indicated for severe RSV infection , hepatitis C infection and other viral infections. Ribavirin is a prodrug, which when metabolised resembles purine RNA nucleotides...
) - ToxinToxinA toxin is a poisonous substance produced within living cells or organisms; man-made substances created by artificial processes are thus excluded...
s (e.g., snakeSnakeSnakes are elongate, legless, carnivorous reptiles of the suborder Serpentes that can be distinguished from legless lizards by their lack of eyelids and external ears. Like all squamates, snakes are ectothermic, amniote vertebrates covered in overlapping scales...
venom; plant poisons such as aesculinAesculinAesculin, also rendered Æsculin or Esculin, is a glucoside that naturally occurs in the horse chestnut , California Buckeye and in daphnin ....
) - Trauma
- MechanicalMechanical hemolytic anemiaMechanical hemolytic anemia is a form of hemolytic anemia due to mechanically induced damage to red blood cells. Red blood cells, while flexible, may in some circumstances succumb to physical shear and compression. This may result in hemoglobinuria. Some forms are self-inflicted , if not...
(from heart valveHeart valveA heart valve normally allows blood flow in only one direction through the heart. The four valves commonly represented in a mammalian heart determine the pathway of blood flow through the heart...
s, extensive vascular surgery, microvascular disease, repeated mechanical vascular trauma)
- Mechanical
- Microangiopathic hemolytic anemiaMicroangiopathic hemolytic anemiaIn medicine microangiopathic hemolytic anemia is a microangiopathic subgroup of hemolytic anemia caused by factors in the small blood vessels. It is identified by the finding of anemia and schistocytes on microscopy of the blood film.-Presentation:It is referred as Runner's anemia...
(a specific subtype with causes such as TTP, HUS, DIC and HELLP syndrome) - Infections (Note: Direct Coombs test is sometimes positive in hemolytic anemia due to infection)
- MalariaMalariaMalaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...
- BabesiosisBabesiosisBabesiosis is a malaria-like parasitic disease caused by infection with Babesia, a genus of protozoal piroplasms. After trypanosomes, Babesia are thought to be the second most common blood parasites of mammals and they can have a major impact on health of domestic animals in areas without severe...
- SepticemiaSepsisSepsis is a potentially deadly medical condition that is characterized by a whole-body inflammatory state and the presence of a known or suspected infection. The body may develop this inflammatory response by the immune system to microbes in the blood, urine, lungs, skin, or other tissues...
- Malaria
- Membrane disorders
- Paroxysmal nocturnal hemoglobinuriaParoxysmal nocturnal hemoglobinuriaParoxysmal nocturnal hemoglobinuria , sometimes referred to as Marchiafava-Micheli syndrome, is a rare, acquired, potentially life-threatening disease of the blood characterised by complement-induced intravascular hemolytic anemia , red urine and thrombosis...
(rare acquired clonal disorder of red blood cell surface proteins) - Liver diseaseLiver diseaseLiver disease is a broad term describing any single number of diseases affecting the liver.-Diseases:* Hepatitis, inflammation of the liver, caused mainly by various viruses but also by some poisons , autoimmunity or hereditary conditions...
- Paroxysmal nocturnal hemoglobinuria
Drug induced hemolysis
Drug induced hemolysis has large clinical relevance. It occurs when drugs actively provoke red blood cell destruction. It can be divided in the following manner:- Drug-induced autoimmune hemolytic anemiaDrug-induced autoimmune hemolytic anemiaDrug-induced autoimmune hemolytic anemia is a form of hemolytic anemia.Penicillin in high doses can induce immune mediated hemolysis via the hapten mechanism in which antibodies are targeted against the combination of penicillin in association with red blood cells...
- Drug-induced nonautoimmune hemolytic anemiaDrug-induced nonautoimmune hemolytic anemiaDrug-induced nonautoimmune hemolytic anemia is a form of hemolytic anemia.Non-immune drug induced hemolysis can occur via oxidative mechanisms. This is particularly likely to occur when there is an enzyme deficiency in the antioxidant defense system of the red blood cells...
A total of four mechanisms are usually described, but there is some evidence that these mechanisms may overlap.