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Hemolytic anemia

Última revisão: 6 Aug 2025
Última atualização: 19 Dec 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • pallor
  • jaundice
Detalhes completos

Outros fatores diagnósticos

  • fatigue
  • shortness of breath
  • dizziness
  • splenomegaly
  • active infections
  • episodic dark urine (hemoglobinuria)
  • triggered by exposure to cold
Detalhes completos

Fatores de risco

  • autoimmune disorders
  • lymphoproliferative disorders
  • prosthetic heart valve
  • family origin in Mediterranean, Middle East, Africa, or Southeast Asia
  • family history of hemoglobinopathy or red blood cell membrane defects
  • paroxysmal nocturnal hemoglobinuria
  • recent exposure to cephalosporins, penicillins, quinine derivatives, or nonsteroidal anti-inflammatory drugs
  • recent exposure to naphthalene or fava beans
  • thermal injury
  • exceptional exertion
  • recent exposure to nitrites, dapsone, ribavirin, or phenazopyridine
  • recent paraquat ingestion
  • malaria
  • babesiosis
  • bartonellosis
  • leishmaniasis
  • Clostridium perfringens infection
  • Haemophilus influenzae type B infection
  • liver disease
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • CBC
  • MCHC
  • reticulocyte count
  • peripheral smear
  • unconjugated (indirect) bilirubin
  • LDH
  • haptoglobin
  • urinalysis
Detalhes completos

Investigações a serem consideradas

  • direct antiglobulin test (Coombs)
  • creatinine, BUN
  • LFTs
  • Donath-Landsteiner antibody
  • Hb electrophoresis
  • flow cytometry for CD55/CD59
  • glucose-6-phosphate dehydrogenase (G6PD) fluorescent spot test and spectrophotometry
  • antinuclear antibody
Detalhes completos

Algoritmo de tratamento

AGUDA

acquired: direct antiglobulin test (Coombs) positive

acquired: direct antiglobulin test (Coombs) negative

inherited disorders

Colaboradores

Autores

John Densmore, MD, PhD

Associate Professor of Clinical Medicine

Department of Medicine

University of Virginia

Charlottesville

VA

Declarações

JD declares that he has no competing interests.

Agradecimentos

Dr John Densmore would like to gratefully acknowledge Dr Michelle Loch, a previous contributor to this monograph. ML declares that she has no competing interests.

Revisores

Pasquale Niscola, MD

Hematology Unit

Sant'Eugenio Hospital

Rome

Italy

Declarações

PN declares that he has no competing interests.

Alan Lichtin, MD

Staff Hematologist-Oncologist

Hematologic Oncology and Blood Disorders

Cleveland Clinic

Associate Professor

Internal Medicine

Cleveland Clinic Lerner College of Medicine

Cleveland

OH

Declarações

AL declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Go RS, Winters JL, Kay NE. How I treat autoimmune hemolytic anemia. Blood. 2017 Jun 1;129(22):2971-9 Resumo

Hill QA, Stamps R, Massey E, et al. The diagnosis and management of primary autoimmune haemolytic anaemia. Br J Haematol. 2017 Feb;176(3):395-411.Texto completo  Resumo

Hill QA, Stamps R, Massey E, et al. Guidelines on the management of drug-induced immune and secondary autoimmune, haemolytic anaemia. Br J Haematol. 2017 Apr;177(2):208-20.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Hemolytic anemia images
  • Diagnósticos diferenciais

    • Anemia due to blood loss
    • Underproduction anemia
    • Transfusion reaction
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  • Diretrizes

    • Diagnosis and treatment of autoimmune hemolytic anemia in adults
    • Recommendations regarding splenectomy in hereditary hemolytic anemias
    Mais Diretrizes
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    Peripheral intravascular catheter: animated demonstration

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