Haemolytic disorders
Classifying haemolysis (intravascular or extravascular, immune or not), reading the DAT and film, warm AIHA (prednisolone, early rituximab), cold agglutinin disease, drug-induced haemolysis, hereditary spherocytosis, G6PD deficiency and oxidant drugs, PNH with complement inhibitors and their vaccination needs, and the complications that catch people out.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Haemolysis is red cell destruction faster than the marrow can replace. Suspect it with anaemia, a high reticulocyte count, raised LDH and unconjugated bilirubin, and low haptoglobin. The screen and the place of haemolysis in the anaemia work-up are in Anaemia.
- Two questions sort most cases: is the DAT positive (immune or not), and what does the film show (spherocytes, schistocytes, bite cells, agglutination)?
- Warm autoimmune haemolytic anaemia (AIHA) is the commonest acquired cause in adults; G6PD deficiency and hereditary spherocytosis are the commonest inherited ones in practice.
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Sources
- Fabhalta (iptacopan) Australian Product Information, boxed warning (pneumococcal and meningococcal vaccination required, Hib recommended, at least 2 weeks before the first dose)AU/NZmedsinfo.com.au (sponsor Product Information), October 2026
- Empaveli (pegcetacoplan) Australian product informationAU/NZTherapeutic Goods Administration, 19 December 2025
- The diagnosis and management of primary autoimmune haemolytic anaemiaHill QA et al., Br J Haematol 2017;176:395-411 (British Society for Haematology), 2017
- Guidelines on the management of drug-induced immune and secondary autoimmune, haemolytic anaemiaHill QA et al., Br J Haematol 2017;177:208-220 (British Society for Haematology), 2017
- Diagnosis and treatment of autoimmune hemolytic anemia in adults: recommendations from the First International Consensus MeetingJäger U et al., Blood Rev 2020;41:100648, 2020
- Guidelines for the diagnosis and management of hereditary spherocytosis: 2011 updateBolton-Maggs PHB et al., Br J Haematol 2012;156:37-49, 2011
- Australian Immunisation Handbook: meningococcal diseaseAU/NZAustralian Government Department of Health, Disability and Ageing
- Iptacopan (Fabhalta) 200 mg capsule, PBS item 15064W (PNH, Authority Required)AU/NZPharmaceutical Benefits Scheme, Accessed November 2026
- Therapeutic Guidelines (eTG complete): haematology topicsAU/NZTherapeutic Guidelines Limited
- Last updated
- 14 November 2026
What changed
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