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Diagnosis of hemolytic anemia in the adult

Stanley L Schrier, MD
Section Editor
William C Mentzer, MD
Deputy Editor
Jennifer S Tirnauer, MD


Hemolytic anemia is defined as anemia due to a shortened survival of circulating red blood cells (RBCs) due to their premature destruction. There are numerous causes of hemolytic anemia, including inherited and acquired conditions, acute and chronic processes, and mild to potentially life-threatening severity. Occasionally the cause will be obvious from the history, physical examination, or findings on the peripheral blood smear, but often the ultimate diagnosis requires a synthesis of all of this information and additional laboratory testing.

The key finding that suggests hemolytic anemia is an increase in the reticulocyte count that is not explained by recent bleeding or recent correction of iron deficiency or other nutrient deficiency. Patients may also have evidence of RBC destruction including increased lactate dehydrogenase (LDH) and bilirubin, decreased haptoglobin, and spherocytes on the peripheral blood smear.

The causes of hemolytic anemia and a diagnostic approach to the adult with unexplained hemolytic anemia are discussed here. Other topic reviews present general approaches to determining the cause of anemia and diagnosis of specific types of hemolytic anemia:

General approach, child – (See "Approach to the child with anemia".)

General approach, adult – (See "Approach to the adult patient with anemia".)

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Literature review current through: Nov 2017. | This topic last updated: Jul 18, 2016.
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