Niedokrwistości ze szczególnym uwzględnieniem anemii immunohemolitycznych – cz. II

Evaluation of anemia – part II

Chemicals and Plants

Oxidants

Most chemicals and plants that cause hemolytic anemia are oxidants. Intoxication with these chemicals results in formation of Heinz bodies and eccentrocytes, and/or the presence of methemoglobinemia. Dietary causes of Heinz body hemolytic anemia in small animals (with or without eccentrocytosis and/or methemoglobinemia) include consumption of onions and garlic. Heinz body hemolytic anemia has occurred following the administration of a variety of drugs including acetaminophen and methylene blue in cats and dogs, methionine and phenazopyridine in cats, menadione (vitamin K3) in dogs.

Venoms

Venoms from snakes, bees, wasps, and brown recluse spiders are complex mixtures of proteins, peptides, enzymes, and chemicals that have multiple pathologic effects, including hemolytic anemia and other forms of tissue injury.

Fragmentation

Microangiopathic hemolytic anemia may occur when erythrocytes are forced to flow through altered vascular channels or are exposed to turbulent blood flow. Erythrocyte fragments with pointed extremities are called schistocytes. Erythrocyte fragmentation may be seen in animals (especially dogs) with DIC. Mechanical fragmentation occurs as the cells pass through the fibrin meshwork of a microthrombus. Fragmentation anemia is especially common in dogs with hemangiosarcoma and in dogs with caudal vena cava syndrome, resulting from a rapid blockage of the posterior vena cava with large numbers of adult heartworms (4).

Hereditary Erythrocyte Defects

Pyruvate Kinase Deficiency in Dogs and Cats

Pyruvate Kinase (PK) deficiency is transmitted as an autosomal recessive trait in many breeds of dogs, with highest prevalence reported in basenjis and beagles. Homozygously affected animals have decreased exercise tolerance, pale mucous membranes, tachycardia, and splenomegaly. Affected young animals have a macrocytic hypochromic anemia (HCT 16% to 28%) with marked ret...

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