Presents with acute or subacute development of fatigue or jaundice, and may include orthostasis and mild splenomegaly.
Anemia, reticulocytosis, low haptoglobin, high LDH, and high indirect bilirubin suggest hemolysis.
Direct antiglobulin test (Coombs) is important for differentiating immune from nonimmune etiologies. Peripheral smear review is important in identifying underlying cause.
Corticosteroids are often first-line therapy in immune-mediated cases. Discontinuation of offending agents (e.g., suspected drugs) and supportive care are the mainstay of treatment for many subtypes.
Early vaccination against encapsulated organisms is important if splenectomy is possible.
Peripheral blood smear with spherocytes, reticulocytes, and a nucleated RBC
From the collection of John Densmore, Department of Medicine, University of Virginia