Differential Diagnosis Of Hemolytic Anemia Research Articles

A Near Fatal Ceftriaxone-Induced Hemolytic Anemia in Pediatric Age: Case Report

This case highlights the importance of recognizing and managing CIIHA promptly to achieve a favorable outcome. It is crucial to consider CIIHA in the differential diagnosis of hemolytic anemia in pediatric patients receiving ceftriaxone and to have a high degree of suspicion in cases of unexplained hemolysis.

PB1976 MICROANGIOPATHIC HEMOLYTIC ANEMIA DUE TO HEART VALVE PROSTHESIS

Background:Microangiopathic hemolytic anemias (MAHA) are characterized by the presence of hemolytic anemia (HA), related to red blood cell (RBC's) fragmentation, thrombocytopenia and hemosiderinuria due the intravascular hemolysis. The term thrombotic microangiopathy (TMA) is also used to describe syndromes characterized by AHMA, thrombocytopenia, and thrombotic lesions in small blood vessels such as Thrombotic Thrombocytopenic Purpura (TTP) and Hemolytic uremic syndrome (HUS). Although TTP and HUS are the prototypes of TMA / MAHA, there are other causes that should not be forgotten, such as MAHA by valvular leak.Aims:Perform the casuistry of the Hematology Service of a Central Hospital for a rare cause of hemolytic anemia.Methods:Parameterized search for the data of patients with MAHA and hemosiderinuria evaluated at a Hematology out patients clinic at a Central Hospital between January 2007 and March 2018.Results:9 patients with MAHA were identified with valvular leak, the mean age at diagnosis was 68 years and 6 were men (66%). All patients had mechanical heart valves: 66% mitral valve, 22% aortic valve and 11% both valves. The time from surgery to diagnosis of AHMA was ∼ 2 years. The mean Hb value was 8.4 mg/dL. All patients had RBC fragmentation. The mean value of DLH was 3773U/L, total bilirubin (TBil) was 1.9 mg/dL. 88% patients were supplemented with oral iron. Only 3 patients increase ∼ 1.5 g of Hb after 3 months of therapy. 1/3 patients were supplemented with EV iron; 1/3 needed blood transfusion. 66% underwent valvular leakage correction and of these 50% significantly improved Hb and hemolysis.Summary/Conclusion:A careful clinical history and the RBC morphology play a central role in the diagnosis of anemia. The MAHA due to leak valvular is a rare entity, but with a tendency to increase. Despite the small number of patients, the authors consider pertinent to present these data because this is a potentially reversible cause of anemia. The disproportionate high DHL level in relation to the TBilis a possible clue to the differential diagnosis of HA.

Uncommon differential diagnosis of hemolytic anemia: case report

Uncommon differential diagnosis of hemolytic anemia: case report

Hemolytic anemia due to acute cytomegalovirus infection in an immunocompetent adult: a case report and review of the literature

IntroductionCytomegalovirus is a common virus responsible for a wide range of clinical manifestations. Hemolysis is a rare but potentially life-threatening complication of cytomegalovirus infection, described mostly in immunocompromised patients, the pathogenesis of which is still unclear.We performed a review of the literature regarding cases of hemolytic anemia during acute cytomegalovirus infection in apparently immunocompetent individuals. We searched for relevant articles in PubMed for the period of 1980 through 2008.Case presentationWe describe a case of Coombs-negative hemolytic anemia in a 44-year-old Caucasian immunocompetent man with acute cytomegalovirus infection.ConclusionClinicians should consider cytomegalovirus infection in the differential diagnosis of hemolytic anemia in immunocompetent adults. Possible therapeutic options include antiviral therapy and steroids, although the best treatment strategy is still controversial.

Flow-Assisted Differential Diagnosis of Hemolytic Anemia with Spherocytosis: A Case Report

In patients with hemolytic anemia associated with spherocytosis, differential diagnosis has to be made whether the hemolysis is immune-mediated or of non-immune origin. We report a case of hereditary spherocytosis in a 12-yr-old male child, in whom flow-assisted diagnosis was made. In this case, diagnosis was not determined because routine laboratory workups for hereditary spherocytosis yielded discrepant positive osmotic fragility test, positive direct antiglobulin test, and normal result in the red cell membrane protein sodium dodecyl succinimide polyacrylamide gel electrophoresis. However, all flow cytometry-based tests, such as osmotic fragility, direct antiglobulin, and eosin 5-maleimide binding test, yielded results compatible with hereditary spherocytosis. Additionally, in family study, the results of eosin 5-maleimide binding test suggested his disease being hereditary. In cases with diagnostic difficulties, flow cytometry may be used as an alternative tool, which can provide additional information in the differential diagnosis of hemolytic anemia with spherocytosis.

Acute Hemolysis and Renal Failure caused by Hepatitis A Infection with Underlying Glucose-6-Phosphate Dehydrogenase Deficiency

Although glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme disorder worldwide, it has rarely been reported among Korean. The patient was previously healthy 39 yr old male who showed severe hemolytic anemia and acute renal failure accompanied by hyperbilirubinemia after hepatitis A infection. The additional studies for differential diagnosis of hemolytic anemia showed a moderate deficiency of G6PD enzyme. Because hepatitis A infection in patient with G6PD deficiency present much more severe clinical symptoms, G6PD enzyme should be examined in patients with triggering factors of hemolysis such as hepatitis A infection.

Hemolytic Anemia with Positive Direct Antiglobulin Test Secondary to Spontaneous Cytomegalovirus Infection in Healthy Adults

Hemolytic anemia with positive direct antiglobulin test in association with spontaneous cytomegalovirus (CMV) infection is a very rare event in healthy adults. We report here 2 patients who have recently suffered from this complication and review similar cases previously reported in the literature. Because CMV serology is not routinely obtained as a part of hemolysis work-up, the true incidence of this complication may be underestimated. We believe that CMV infection should be considered in the differential diagnosis of hemolytic anemia in adults.