title: Non-immune Hemolysis: Diagnostic Considerations.
abstract: Non-immune hemolytic anemia (NIHA) is characterized by positive routine hemolytic tests but negative anti-human immunoglobulin (Coombs) test. Hereditary non-immune hemolysis includes disorders of erythrocytic enzymes, membrane, hemoglobin (qualitative and quantitative disorders), as well as the rare hereditary forms of thrombotic microangiopathies. Acquired NIHA includes paroxysmal nocturnal hemolysis (PNH), infections, drug and metal intoxications with as a target red blood cells or endothelium of capillaries, the rare acquired forms of thalassemia or erythrocytic membrane disorders, and hemolysis secondary to a dysfunctioning artificial (prosthetic) cardiac valve. Identification of the specific cause of NIHA is sometimes difficult and requires not only a good knowledge of this entity but mainly a qualified specialized hematologic laboratory. An algorithm to be used in every new patient consulting for NIHA is proposed in the last part of this article.
authors.affiliation: Service d'Hématologie, Département de Médecine Interne, Centre Médical Universitaire Genève Suisse, Geneva, Switzerland; Département d'hématologie, Laboratoire central Unilabs, Coppet, Switzerland. Electronic address: photis.beris@unilabs.com.
authors.forename: Photis
authors.initials: P
authors.lastname: Beris
authors.affiliation: Service d'Hématologie biologique, Hôpital Bicêtre, AP-HP, Le Kremlin Bicêtre, France; Laboratoire d'Hématologie, Faculté de Pharmacie, Université Paris-Sud, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Picard
mesh_terms: D000818:Animals; D003937:Diagnosis, Differential; D020022:Genetic Predisposition to Disease; D006454:Hemoglobins / Q000032:analysis; D006461:Hemolysis; D006801:Humans
chemical_list: D006454:Hemoglobins