- Intravascular hemolysis: direct mechanical trauma to RBCs (e.g. mechanical valve dysfunction, para-valvular leak), toxins, microangiopathic processes, complement-mediated immune process
- Extravascular hemolysis (premature pahgocystosis of RBCs by macrophages): immune mediated destruction (e.g. autoimmune dz, drug induced hemolysis, infection mediated, cancer), hypersplenism, hemoglobinlopathy (e.g. sickle cell disease), abnormal RBC deformability (e.g. hereditary spherocytosis)
- Fatigue and those related to specific etiology
- Other sx related to specific etiology of hemolysis
- If severe hemolysis→ abnl VS
- Bilirubinuria if intravascular
- Macro or normocytic anemia, reticulocytosis, elevated LDH, elevated indirect bilirubin, low haptoglobin, bilirubinuria
- Review peripheral smear for additional clues