A 72-year-old man who has recently had an aoic valve replacement now presents with pallor and fatigue. The red blood cell count is decreased, and schistocytes are repoed on examination of a peripheral blood smear. In addition, his indirect (unconjugated) bilirubin is significantly elevated. The cause of the anemia is likely
cold agglutinin disease.
dietary deficiency.
hereditary spherocytosis.
mechanical disruption of red cells.
- Turbulent blood flow over mechanical hea valves can cause shearing of RBC, resulting in fragmented cells termed schistocytes. -The hemolysis can result in anemia and hyperbilirubinemia. OTHER OPTIONS: - cold agglutinin disease - Triggered by cool temperatures, hemolysis is d/t antibodies against RBC - Hereditary spherocytosis causes hemolytic anemia d/t intrinsic defect in red blood cells - Dietary deficiencies dont cause fragmented RBC.
Hemoglobinopathies: Sickle cell anemia