TY - CHAP M1 - Book, Section TI - Fragmentation Hemolytic Anemia A1 - Lichtman, Marshall A. A1 - Kaushansky, Kenneth A1 - Prchal, Josef T. A1 - Levi, Marcel M. A1 - Burns, Linda J. A1 - Armitage, James O. PY - 2017 T2 - Williams Manual of Hematology, 9e AB - Acquired erythrocyte fragmentation occurs when red cells are forced at high shear stress through partial vascular occlusions or over abnormal vascular surfaces.In circumstances in which fragmentation of red cells occurs in the microcirculation, it is often referred to as microangiopathic hemolytic anemia.In three primary disorders—thrombotic thrombocytopenic purpura (TTP) (Chap. 90), hemolytic uremic syndrome (HUS) (Chap. 90), and disseminated intravascular coagulation (DIC) (Chap. 85)—microangiopathic (fragmentation) hemolytic anemia is an essential diagnostic feature. These disorders are discussed in other chapters.In addition to signs of hemolysis such as anemia, reticulocytosis, decreased haptoglobin, elevated indirect bilirubin, and sometimes elevated serum lactic dehydrogenase, fragmented red cells (schistocytes) are evident in the blood film (Figure 19–1). Their prevalence may vary.Fragmentation hemolytic anemia syndromes discussed in this chapter include (1) hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome, (2) disseminated malignancy, (3) heart valve hemolysis, (4) march hemoglobinuria, and (5) the Kasabach-Merritt phenomenon. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/07 UR - hemonc.mhmedical.com/content.aspx?aid=1133362971 ER -