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Hemolysis, Pediatric

Julie W. Stern, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

Premature destruction of RBCs, either intravascularly or extravascularly, leading to a shortened red cell survival time. The premature destruction can be caused by intrinsic factors ...

DIAGNOSIS

HISTORY

  • Pallor, fatigue, and jaundice may occur with either intravascular or extravascular hemolysis.

  • Hemoglobinuria is a sign of intravascular hemolysis.

  • General goal is to establish existence...

TREATMENT

GENERAL MEASURES

  • Avoid triggers of hemolysis (i.e., foods, medications, etc.) for patients with known G6PD deficiency.

  • Extended cross-match for minor red cell antigens prior to transfusions in...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • May need ICU for unstable vital signs

  • Inpatient care may be required until acute hemolysis slowed or stopped.

  • Monitor CBC, reticulocyte, LFTs ever...

ADDITIONAL READING

  • Gallagher PG. Update on the clinical spectrum and genetics of red blood cell membrane disorders. Curr Hematol Rep.  2004;3(2):85–91. [View Abstract on OvidInsights]

  • Lo L, Singer...

CODES

ICD9

  • 282.7 Other hemoglobinopathies

  • 283.0 Autoimmune hemolytic anemias

  • 774.0 Perinatal jaundice from hereditary hemolytic anemias

  • 773.1 Hemolytic disease of fetus or newborn due to ABO isoimmunizati...

FAQ

  • Q: When are blood transfusions indicated in patients with active hemolysis?

  • A: Patients with severe, acute hemolysis that is causing cardiovascular compromise may require a transfusion if the proce...

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