Differential Diagnosis of Hemolytic Anemia in a Neonate

A neonate with hemolytic anemia may present with neonatal jaundice, the severity of which depends on the severity of the hemolytic process.

Parameters:

(1) red cell morphology

(2) other findings

Red Cell Morphology	Other Finding(s)	Cause
microscpherocytes	DAT negative; persistent spherocytosis	hereditary spherocytosis
	positive DAT	hemolytic disease of the newborn (ABO, Rh, other)
elliptocytes	DAT negative	hereditary elliptocytosis
bite or blister cells	low G6PD enzyme activity; Heinz bodies; drug exposure	G6PD deficiency
	Heinz bodies, hemoglobin electropheresis	unstable hemoglobin
echinocytes	low pyruvate kinase activity	pyruvate kinase deficiency
	low enzyme activity	other glycolytic enzyme deficiency
schistocytes	elevated D-dimer, thrombocytopenia	DIC
	elevated D-dimer, thrombocytopenia	perinatal asphyxia
	very low ADAMTS13 activity, thrombocytopenia	ADAMTS13 deficiency
	acute renal failure, thrombocytopenia	hemolytic uremic syndrome
	very low protein C, thrombocytopenia	homozygous protein C deficiency
	may be internal or external, thrombocytopenia	giant hemangioma

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