Table 2.

Differential diagnosis of hemolysis in children.

HEREDITARY HEMOLYTIC ANEMIAS

Membrane defects Hereditary spherocytosis Hereditary elliptocytosis and pyropoikilocytosis Southeast Asian ovalocytosis Dehydrated hereditary stomatocytosis or hereditary xerocytosis RBC Overhydration syndromes

Enzymopathies Glucose-6-phosphate dehydrogenase (G6PD) deficiency Pyruvate kinase (PKLR) deficiency Other RBC enzyme disorders (AK1, ALDOA, GCLC, GPI, GPX1, GSR, GSS, HK1, NT5C3A, PFKM, PGK1, TPI1)

Hemoglobin disorders Sickle cell disease Thalassemias Unstable hemoglobins

Congenital dyserythropoietic anemias

ACQUIRED HEMOLYTIC ANEMIAS

Autoimmune hemolytic anemia (AIHA) Warm-reactive AIHA Cold agglutinin syndrome Paroxysmal cold hemoglobinuria (PCH) Drug-induced (very rare in children)

Alloimmune hemolytic anemia Neonatal alloimmune hemolysis Post-transfusion hemolysis Acute hemolytic reactions Delayed hemolytic reactions

Traumatic Hemolytic Anemia Impact Macrovascular defects-prostheses (Waring blender syndrome with a dysfunctional mechanical heart valve) Microvascular Typical and Atypical Hemolytic uremic syndrome Thrombotic thrombocytopenic purpura Disseminated intravascular coagulation

Hypersplenism

Hemolytic Anemia due to toxic effects on the membrane Spur cell anemia in severe liver disease External toxins Animal or spider bites Metals Organic compounds Infection

Paroxysmal nocturnal hemoglobinuria