Abstract
The hemolytic anemias diagnosis remains a clinical challenge. Once a presumptive diagnosis is made based on clinical and laboratory data, the first step is to perform a direct Coombs test. If it is positive, the evaluation should de pointed towards immune haemolytic anemias, among which those mediated by aloantibodies, autoantibodies or drug-related are the most prominent. If the direct Coombs test is negative, we should consider the non-immune haemolytic anemias. The peripheral blood smear review and the familiy history are highly valuable in the diferential diagnosis. Mechanical hemolysis and congenital haemolytic anemias (membrane defects, enzimopathies, hemoglobinopathies, thalassemias…) are the main possibilities.
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