Conceptual framework for inherited hemolytic anemias

Hemoglobinopathies and membrane disorders tend to have characteristic abnormalities of RBC morphology on the peripheral blood smear. Membrane disorders may have nonspecific findings or bite cells on the blood smear. Refer to UpToDate for other distinguishing features among these conditions and the approach to diagnostic testing.

RBC: red blood cell; LDH: lactate dehydrogenase; Hb: hemoglobin; G6PD: glucose-6-phosphate dehydrogenase; PK: pyruvate kinase; SAO: Southeast Asian ovalocytosis; HPP: hereditary pyropoikilocytosis.
* Hemoglobinopathies can often coexist (eg, sickle-beta thalassemia; Hb E-beta thalassemia; Hb SC disease). Not all forms of thalassemia cause hemolysis; hemolysis is seen with hemoglobin H disease and transfusion-dependent beta thalassemia, but not with milder forms of thalassemia such as one or two alpha globin gene deletions or heterozygous beta thalassemia.

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Conceptual framework for inherited hemolytic anemias