Microangiopathic Hemolytic Anemia (MAHA)

Laboratory Evaluation Anemia in the setting of increased reticulocyte count, elevated LDH, decreased haptoglobin, elevated plasma free hemoglobin, elevated indirect bilirubin, and a negative Coomb’s test (see Anemia) raises suspicion for a microangiopathic hemolytic anemia (MAHA). A peripheral smear may elicit schistocytes (see above picture). Initial workup in the suspicion for a microangiopathic hemolytic anemiaContinue reading “Microangiopathic Hemolytic Anemia (MAHA)”

Coagulation

Coagulation Cascade Coagulation Labs PT (Prothrombin Time): Thromboplastin (which contains Tissue Factor) is added to blood and the time needed to clot is recorded. Specifically analyzes the extrinsic pathway (factors II, V, VII, and X, and fibrinogen) (1) INR (International Normalized Ratio): Because of variability in thromboplastin reagent mixtures around the world, the INR wasContinue reading “Coagulation”

Blood Transfusion Reactions

Seconds-minutes Anaphylaxis IgE-mediated hypersensitivity Rash, angioedema, wheezing, hypotension Management: Intramuscular epinephrine injection + steroids Minutes-hours Acute Hemolytic Reaction Recipient antibodies to donor RBC antigens (usually ABO antigens), as a result of improper cross-matching prior to administration Fever, chills, flank pain, hemoglobinuria, potentially progressing to renal failure and DIC High unconjugated bilirubin, high LDH, low haptoglobin,Continue reading “Blood Transfusion Reactions”