Causes of Extravascular and Intravascular Hemolysis - Differential Diagnosis Algorithm

Extravascular - Spleen and RES-mediated hemolysis

 - Immune-Mediated

     • Warm AIHA

     • Cold AIHA

     • Alloimmune delayed HTR

     • Drug-induced AIHA

 - Abnormal Hgb & Hgb Defects

     • Thalassemia

     • Sickle cell

     • Unstable Hgb

 - Membrane Defects

     • Hereditary spherocytosis

     • Hereditary elliptocytosis 

 - RBC Enzyme Defects

     • G6PD deficiency

     • PK deficiency

Intravascular - Hemolysis within circulation

 - Infections

     • Malaria

     • Babesiosis

     • C. perfringens

 - Complement-Mediated

     • Cold AIHA

     • PCH

     • PNH

     • Drug-induced immune-complex hemolytic anemia

     • Acute HTR

 - Mechanical Shearing

     • MAHA (TTP, DIC, HUS)

     • Prosthetic heart valves

     • Atriovenous malformations



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