Haemolytic anaemia encompasses a number of conditions that result in the premature destruction of RBCs. The causes can be divided into inheritied and acquired, it can also be due to a underlying malignancy

Features

• Anaemia - Reduction in circulating RBC
• Splenomegaly - Spleen becomes filled wtih destroyed RBC
• Jaundice - Released bilirubin during destruction of RBC

Investigations

• FBC - normocytic anaemia, increased reticulocytes
• Blood film - Schistocytes (fragments of RBC)
• Raised unconjugated bilirubin
• Haptoglobin (a plasma protein that binds free Hb in blood), Bound haptoglobin is ingested by macrophages - In haemolytic anaemia haptoglobin is low as it is being consumed
• LDH - high.
  • High LDH + low haptoglobin is 90% specific for haemolytic anaemia

Inheritied haemolytic anaemias

Hereditary spherocytosis

• Hereditary Elliptocytosis - Very similar to hereditary spherocytosis except the RBC are ellipse shaped. Also autosomal dominant inheritance. PC and Management are the same.
• Hereditory stomatocytosis - red cells in which the pale central area appears slit like, excess alcohol intake is a common cause.

Sickle cell anaemia

Thalassaemia