The cause of chronic hemolytic anemia over a
period of time may result in splenomegaly.
Now, a very important point,
you can have a patient that
has hereditary spherocytosis,
and unfortunately, concomitantly may also
have an infection with parvovirus B19.
As soon as you see
you reflexibly go to
bone marrow shutdown,
and you go to the other branch
of your normocytic anemia.
And what would that be?
Non-hemolytic anemia, is that clear?
Next, diagnosis, as we said earlier
would be the osmotic fragility test,
what are you going to do?
Tell me about the hemoglobin
concentration in that RBC?
You put this into a hypotonic
solution, what happens?
The cell is going to swell.
Next, I asked you or I told you
that that particular peripheral blood
smear where you’d find a spherocyte
shares a differential with
which other condition?
A warm autoimmune hemolytic anemia.
But here, under hereditary spherocytosis,
it’s not an autoimmune disease,
and so therefore, it
will be Coombs negative
so that’s your immunoglobulin
type of test.
And there are no antibodies here, clear?
Hence, the Coombs will be negative.
Keep that in mind.
That’s an important slide to go through
in terms of proper understanding
clinically of your