Hemolytic Anemias.

Intrinsic (intracorpuscular) abnormalities of red cells

Disorders of membrane cytoskeleton:

Spherocytosis

elliptocytosis

Red cell enzyme deficiencies:

pyruvate kinase deficiency

hexokinase deficiency

glucose 6 phosphate dehydrogenase deficiency

Disorders of hemoglobin synthesis:

Deficient globin synthesis: thalassemia syndromes

Structurally abnormal globin synthesis (hemoglobinopathies): sickle cell anemia, unstable hemoglobins

Acquired membrane defect:

paroxysmal nocturnal hemoglobinuria

Extrinsic (extracorpuscular) abnormalities:

Antibody mediated:

Isohemagglutinins: transfusion reactions, erythroblastosis fetalis

Autoantibodies: idiopathic (primary), drug-associated, systemic lupus erythematosus, malignant neoplasms, mycoplasmal infection

Mechanical trauma to red cells:

Microangiopathic hemolytic anemias( MAHA): thrombotic thrombocytopenic purpura, disseminated intravascular coagulation

Prosthetic heart valves

Infections: malaria, hookworm:

Chemical injury: lead poisoning

Sequestration in mononuclear phagocyte system: hypersplenism

Impaired Red Cell Production

Disturbance in stem cells:

aplastic anemia

pure red cell aplasia

anemia of CRF

Disturbance of proliferation and maturation of erythroblasts:

Defective DNA synthesis:

deficiency vitamin B12 and folic acid (megaloblastic anemias)

Defective hemoglobin synthesis

Deficient heme synthesis: iron deficiency

Deficient globin synthesis: thalassemias

Unknown or multiple mechanisms:

sideroblastic anemia

anemia of chronic infections

myelophthisic anemias due to marrow infiltrations