Acquired Hemolytic Anemia - Non-immune

Non-immune

Non-immune mediated hemolytic anemia (direct Coombs test is negative)

• Drugs (i.e., some drugs and other ingested substances lead to hemolysis by direct action on RBCs, e.g. ribavirin )
• Toxins (e.g., snake venom; plant poisons such as aesculin)
• Trauma
  • Mechanical (from heart valves, extensive vascular surgery, microvascular disease, repeated mechanical vascular trauma)
• Microangiopathic hemolytic anemia (a specific subtype with causes such as TTP, HUS, DIC and HELLP syndrome)
• Infections (Note: Direct Coombs test is sometimes positive in hemolytic anemia due to infection)
  • Malaria
  • Babesiosis
  • Septicemia
• Membrane disorders
  • Paroxysmal nocturnal hemoglobinuria (rare acquired clonal disorder of red blood cell surface proteins)
  • Liver disease