Episode 091: Heme Consult Series: Intro to Acquired Hemolytic Anemia and G6PD Deficiency
Feb 6, 2024
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The podcast discusses hemolytic anemias, including the workup for acquired hemolytic anemias and G6PD deficiency. They cover when to suspect these conditions and the importance of tailored clinical assessment and management strategies.
Recognizing symptoms of hemolysis like jaundice and dark urine is crucial for diagnosing hemolytic anemias.
Understanding the complexity of G6PD deficiency, its severity range, and triggers assists in effective patient management.
Deep dives
Understanding Hemolytic Anemias
Hemolytic anemias are crucial for hematologists to grasp, often presenting as unexplained acute anemia associated with homolysis, the breakdown of red blood cells. Symptoms indicating homolysis include jaundice, dark urine, and abdominal pain. Key considerations for diagnosis involve evaluating the patient's history, recent medications, illnesses, and family history of anemia. Laboratory tests like CBC, reticulocyte count, LDH, and the direct antiglobulin test (DAT) play a significant role in confirming hemolytic anemias.
The Significance of DAT Test and Illusion Screen
The Direct Antiglobulin Test (DAT) gauges antibodies binding to red blood cells, vital in identifying homolysis causes. Results indicated Warm Autoimmune Hemolytic Anemia (WAIHA) or Cold Agglutinin Disease based on IgG and C3 positivity. The Illusion Screen further confirms antibodies targeting red blood cell antigens. Understanding these tests aids in diagnosing hemolytic anemias and guiding treatment plans.
G6PD Deficiency and Diagnostic Challenges
G6PD deficiency, a common enzyme defect affecting red blood cells, poses challenges in diagnosis due to various mutations and activity fluctuations. The deficiency's severity ranges, affecting energy generation pathways in cells. Clinical symptoms and triggers can indicate G6PD issues, necessitating caution with medications like Daraprim. Understanding the complexity of G6PD deficiency aids in effective patient management.
It’s time for another heme consult series, this time focusing on hemolytic anemias. In this multi-part series, we will go through our approach to thinking about concerns for hemolytic anemias. This is super high yield for anyone who cares for patients, especially those in hematology/oncology. It’s not uncommon to get a consult on the heme consult service for assistance with diagnosis and management of suspected hemolytic anemias!
Content:
- What is "hemolytic anemia"?
- When should we suspect hemolytic anemias?
- What is the workup for acquired hemolytic anemias?
- What is G6PD deficiency? When should we suspect this?
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