Hemolytic anemia

Last revised by Daniel J Bell on 31 Jan 2024

Hemolytic anemia is a form of anemia where red blood cells are destroyed faster than they can be replaced. This may happen either intravascularly or extravascularly.

The patient presents with anemia and jaundice. Diagnosis is based on several laboratory parameters 1:

  • reticulocytosis

    • suggested by a raised mean cell volume (MCV)

    • can be confirmed on a blood film

  • increased unconjugated bilirubin

  • increased lactate dehydrogenase

  • decreased haptoglobin

With the excessive red cell destruction, there is compensatory erythroid hyperplasia in the bone marrow, resulting in increased production of erythroid precursors (reticulocytosis).

Hemolytic anemia can be due to defects in:

Chronic hemolytic anemia may present on imaging as marrow reconversion and/or splenomegaly. Some underlying causes of hemolytic anemia (e.g. sickle cell disease) have more specific imaging findings (see the relevant articles for more details).

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