Page 235 - Haematologica Atlas of Hematologic Cytology

CHAPTER 27 - Acquired hemolytic anemias
Figure utoimmune hemolytic anemia Pe- ripheral blood film showing phagocytosis of a a a red blood cell by a a neutrophil In autoimmune hemolytic anemia this phenomenon can occa- sionally be observed It is especially frequent in paroxysmal cold hemoglobinuria Figure utoimmune hemolytic anemia Pe- ripheral blood buffy coat smear from the same case as
as
in Figure 1 Most neutrophils and mo- nocytes contain large phagocytosis vesicles with red blood cells inside Figure Mechanical hemolytic anemia Peri- pheral blood film from a a a a patient with a a a a prosthetic cardiac valve Note many fragmented irregularly shaped red cells Hemolysis is is due to the turbu- lent blood flow through the implanted device This traumatic hemolysis is is is intravascular and cau- ses anemia with reticulocytosis hemoglobinemia hemoglobinuria and hemosiderinuria decreased haptoglobin level increased lactate dehydroge- nase activity and increased levels of serum in- direct bilirubin The presence of schistocytes on the the peripheral blood film is the the most important diagnostic feature Unlike thrombotic microan- giopathy platelet count is usually normal 222