Hemolytic Anemia - Differential Diagnosis Algorithm
 • Sickle cells - Consider sickle cell disease (diverse genotypes): SS, SC, SE, Sβ thalassemia, S Lepore
 • Basophilic stippling - Congenital 5' nucleotidase deficiency, lead poisoning
 • Polychromasia only with or without platelet decrease - PNH
 • Polychromasia without other reproducible morphologic abnormality - Pyruvate kinase deficiency, Hexokinase deficiency, Other enzyme defects
 • Agglutination - Cold agglutinins disease
 • Heinz bodies - Glucose-6-phosphate dehydrogenase deficiency, Unstable hemoglobin defects, Glutathione metabolism defects, Hemoglobin H disease
 • Schistocytes, thrombocytopenia - DIC, TTP, HELLP, HUS, aHUS, mechanical cardiac valve, vasculitis, malignant hypertension
 • Unusual RBC inclusions - If infection suspected, consider malaria, bartonella (oroya fever), babesia
 • Spherocytes, pyropoikilocytes, elliptocytes or acanthocytes - Consider RBC membrane disorder (hereditary spherocytosis, hereditary elliptocytosis, autoimmune hemolysis)

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