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8.2: Macroangiopathic Hemolytic Anemias

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    Traumatic Cardiac Hemolytic Anemia

    In this condition, hemolysis is due to mechanical trauma caused by prosthetic cardiac valves. High blood flow around the prosthetic causes red blood cells to fragment leading to intravascular hemolysis. Any damaged cells that do not hemolyze in circulation are removed by the spleen via extravascular hemolysis.1,2

    Hemolytic anemia due to traumatic cardiac causes is uncommon and platelet count is not usually decreased drastically. Any hemolysis that occurs is often compensated by the bone marrow.1,2

    Laboratory Findings for Traumatic Cardiac Hemolytic Anemia:2

    CBC:

    PLT: Normal

    Hb: Decreased

    RETIC: Increased

    PBS:

    Schistocytes

    Other Tests:

    Unconjugated Bilirubin: Increased

    LD: Increased

    Haptoglobin: Decreased


    Exercise-induced Hemoglobinuria

    Transient hemolysis that occurs due to stress caused by exercise. Most often due to activities involving contact with hard surfaces such as running. Red blood cells become damaged as they pass through small vessels. Anemia usually does not develop unless hemolysis is severe.1

    Laboratory Findings for Exercise-induced Hemoglobinuria:2

    CBC:

    Hb: Increased

    RETIC: Increased

    MCV: Slight increase

    PBS:

    Schistocytes are NOT present

    Other Tests:

    Unconjugated Bilirubin: Increased

    LDH: Increased

    Haptoglobin: Decreased

    Hemoglobinuria


    Thermal Injury

    Hemolytic anemia can develop after thermal burns to the body. Degree of hemolysis is dependent on the amount of surface area affected. Hemolysis is due to direct thermal damage to the red blood cells.1

    Laboratory Findings for Thermal Injury:1

    CBC:

    Hb: Decreased

    PBS:

    Schistocytes

    Micro-Spherocytes

    Other Tests:

    Hemoglobinuria


    References:

    1. Smith LA. Hemolytic anemia: nonimmune defects. In: Clinical laboratory hematology. 3rd ed. New Jersey: Pearson; 2015. p.372–87.

    2. Keohane EM. Extrinsic defects leading to increased erythrocyte destruction – nonimmune causes. In: Rodak’s hematology clinical applications and principles. 5th ed. St. Louis, Missouri: Saunders; 2015. p. 394-410.


    This page titled 8.2: Macroangiopathic Hemolytic Anemias is shared under a CC BY-NC 4.0 license and was authored, remixed, and/or curated by Valentin Villatoro and Michelle To (Open Education Alberta) via source content that was edited to the style and standards of the LibreTexts platform.