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Hemolytic anemia is characterized by premature destruction of red blood cells and compensatory erythroid hyperplasia. Additional features include increased reticulocyte values, increased unconjugated serum bilirubin and decreased (or absent) serum haptoglobin. Causes can be grouped as follows: due to internal abnormalities of red blood cells (e.g., enzyme defects, hemoglobinopathies); abnormalities of the red cell membrane (e.g., hereditary spherocytosis, paroxysmal nocturnal hemoglobinuria, spur cell anemia); and extrinsic factors (e.g., splenomegaly, drug-induced antibodies, microangiopathic hemolysis, infections, toxins).
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