The diagnosis of cold-antibody AIHA is made with the presence of hemolytic anemia,
reticulocytosis, hyperbilirubinemia, increased LDH level, and classically, a negative Coombs test with anti-IgG and a positive Coombs test with anti-C3 (7).
On the other hand, lack of
reticulocytosis in these animals can be explained by an increase in the total BM apoptosis, confirmed by an increase of apoptotic marker Caspase-3 and a simultaneous decrease of the antiapoptotic protein Bcl-[x.sub.L].
Case BIII.1 had mild microcytic anaemia,
reticulocytosis, and increased ferritin levels; 17% of stomatocytes were detected at blood smear examination (Table 1 and Figure 2); the molecular testing for HBB gene revealed the presence of the splicing mutation c.93-21G>A at heterozygote level, confirming the beta-thalassemia trait.
The girl recovered after 3 days with
reticulocytosis of 16%, while the boy recovered 8 days later with
reticulocytosis of 8%.
Haemolytic crisis may be distinguished from aplastic crisis by the finding of a
reticulocytosis as opposed to a reticulocytopenia.
9.Hematologic Hemolytic anemia with
reticulocytosisMaturity at birth time of presentation presence of anemia and hyperbilirubinemia and
reticulocytosis were not significantly different between G6PD deficient and G6PD normal neonates.
Her previous investigations revealed thrombocytopenia, schistocytic anaemia with fragmented RBCs on peripheral smear and
reticulocytosis. Renal function tests, haemoglobin electrophoresis, Coomb's and osmotic fragility tests done in the past were normal.
Hemolytic anemia with
reticulocytosis or Leukopenia <4.000/[mm.sup.3] on [greater than or equal to] 2 occasions or Lymphopenia <1.500/[mm.sup.3] on [greater than or equal to] 2 occasions or Thrombocytopenia <100.000/[mm.sup.3] in the absence of offending drugs.
Additional findings include increased indirect bilirubin,
reticulocytosis, and a sharp decrease in haptoglobin.
Hemoglobinuria (not hematuria), unconjugated bilirubinemia (3.35 mg%), elevated LDH (491 U/L), normal vitamin B12 (439 pg/mL), and normal folic acid (13.24 ng/mL) were noted; therefore, her macrocystosis (MCV: 106.7 fL) was considered to be associated with her marked
reticulocytosis.
Reticulocytosis and plasma erythropoietin increases indicated that this was similar to the mechanism in this patient.
