Hemolytic anemia

Hemolytic anemia is characterized by the premature destruction of red blood cells.

Anemia, reticulocytosis, low haptoglobin, high lactate dehydrogenase, and high indirect bilirubin suggest hemolysis.

Direct antiglobulin test (Coombs) is important for differentiating immune from nonimmune etiologies. Peripheral smear review is important in identifying underlying cause.

Corticosteroids are often first-line therapy in immune-mediated cases. Discontinuation of offending agents (e.g., suspected drugs) and supportive care are the mainstay of treatment for many subtypes.

Early vaccination against encapsulated organisms is important in cases that may be treated with splenectomy.

Hemolytic anemia encompasses a number of conditions that result in the premature destruction of red blood cells. Common causes include autoantibodies, medications, and underlying malignancy, but the condition can also result from a number of hereditary conditions, such as hemoglobinopathies.