Extrinsic haemolytic anaemia
Immune causes:
- iso-immune - incompatibility, for example haemolytic disease of the newborn, blood transfusion incompatibility
- autoimmune haemolytic anaemia
Non-immune causes:
- red cell fragmentation:
- in patients with prosthetic valves
- "march haemoglobinuria" in soldiers and marathon runners
- direct shearing of red cells in disseminated intravascular coagulation
- thrombotic thrombocytopenia purpura
- sequestration in mononuclear phagocyte system - hypersplenism
- infections e.g. malaria, black water fever, Clostridium welchii
- chemicals e.g. lead, drugs, toxins
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