[Etiology of hemolytic anemia]

When hemolytic anemia is diagnosed the etiology of most cases can be determined by simple methods: familial and personal history, physical examination and search for erythrocyte morphologic anomalies (spontaneous or induced). These latter are often typical of a particular mechanism of hemolysis. The antihuman globulin test and the screening test for G-6-PD deficiency and sickle cell anemia are included in the routine tests. More specialized tests should be performed only in doubtful cases. For example, the determination of erythrocyte survival by an isotopic method may confirm suspected mild hemolysis. Measurement of several enzyme activities may detect an enzymatic deficiency. Hemoglobin electrophoresis may reveal hemoglobinopathy.