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ANEMIA HEMOLITICA
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Etiologia, factores de riesgo, clasificaciones, fisiopatologia, manifestaciones clinicas, diagnostico y tratamiento
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ANEMIA HEMOLÍTICADestrucción de hematíes
Velocidad de destrucción es mayor a velocidad de regeneración
Datos de hemólisis
● Hiperbilirrubinemia
● Hepatoesplenomegalia
● Reticulocitos ELEVADOS
● BCG ELEVADA
● LDH ELEVADA
CLASIFICACIÓN
- Intracorpusculares → Defecto en eritrocitos (hereditaria) , talasemias
son ejemplo
- Extracorpuscular → Acción externa al mismo (adquirida), valvulopatías,
hiperesplenismo, radiación
CLÍNICA
● Anemia normocítica normocrómica
● LDH ELEVADA
● Reticulocitos ELEVADOS
ANEMIAS HEMOLÍTICAS CONGÉNITAS
1. Defectos de membrana
2. Enzimopatías o trastornos de metabolito
3. Defectos de Hb (talasemias, anemias por células falciformes)
ESFEROCITOSIS HEREDITARIA (defecto en membrana)
● Anemia hemolítica más frecuente
● Trastorno de proteínas
- Ankirina 50%
- Banda 3 25%
- Espectrina 25%
● Anclaje defectuoso de glóbulos rojos → Aumento de permeabilidad
Na/H2O
● Se ven como esferas en frotis de sangre periférica
Hay eritropoyesis extramedular y quedan los eritrocitos atrapados en
sinusoides y bazo
DIAGNÓSTICO
● Clínica de anemia hemolítica
● CHCM ELEVADA
● Prueba de fragilidad osmótica
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