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Clinical features of Hemolytic Anemia

Hemolytic anemia is characterised by features due to increased Hemolysis that is reduced  RRC life span and features due to Erythropoetic response of the bone marrow
Features due to Increased Hemolysis -Reduced  RRC life span
  • Hemoglobin: reduced
  • Increase in unconjugated bilirubin
  • Elevated LDH
  • Increased AST
  • Reduced  Haptoglobin
  • Increased  Urobilinogen in urine (& stool)
  • Increased  Stercobilinogen in stool
  • Hemoglobinuria (intravasculae  hemolysis)

Features due to Ervthropoetic response of the bone marrow
  • Increase in  Reticulocytes (Reticulocytosis)
  • Increase in  MCV/MCH  this is due to the increased number of reticulocytes
  • Peripheral smear - Macrocytes, Polychromasia & sometimes nucleated red cells in smear. Routine bloodfilm shows a varietyt of abnormal morphological type of red cells such as Schistocytes ,Spherocytes  etc.
  • Bone narrow shows erythroid hyperplasia( Myeloid: Erythroid Ratio is decreased)with raised iron stores.
  • X Rays of bones show evidence of expansion of marrow space, especially in tabular bones & in skull rsulting in bossing of skull