classification of Hemolytic anemias

Classification of Hemolytic anemia

HEREDITARY CAUSES

Inherited genetic defects 

1. Red cell membrane defects – Heriditary spherocytosis, Hereditary elliptocytosis

2. Enzyme deficiencies 

                       a. Hexose monophosphate shunt enzyme deficiencies – G-6-PD dificiency

                       b. Glycolytic enzyme deficiency  –   Pyruvate kinase deficiency, Hexokinase deficiency

Hemoglobin abnormalities 

1. Deficient globin synthesis – Thalassemia

2. Structurally abnormal globins  –  Sickle cell disease

ACQUIRED CAUSES

Acquired Genetic defects 

1. Deficiency of phosphatidylinositol – linked glycoproteins – Paroxysmal nocturnal hemoglobinuria

Antibody mediated destruction

• Hemolytic disease of newborn

• Transfusion reactions

• Autoimmune disorders

• Drug – induced

Mechanical trauma 

1. Microangiopathic hemolytic anemias – Hemolytic uremic syndrome, TTP, DIC

2. Cardiac traumatic hemolysis – Defective cardiac valves

3. Repetitive physical trauma – Marathon running, Karate chopping

Infections of RBC – Malaria, Babesiosis

Toxic chemical injuries – Snake venum, Lead poisoning, Clostridial sepsis

Membrane lipid abnormalities – Abetalipoproteinemia, Severe liver disease

Sequestration – Hypersplenism

 

Reference : Robbins & Cotrans Pathologic Basis of Disease (9th edition)

 

By 

Dr.G.Bhavana (Associate professor, Pathology, Narayana Medical College, Nellore)

Edited by Dr. V.Shanthi ( Professor of Pathology, Narayana Medical College, Nellore)