A clinical evaluation on 24 cases of the patients with hemolytic anemias in National
Medical Center during recent 10 years from January 1970 to December 1979 showed the
following findings;
1) 24 cases of the hemolytic anemia could be classified according to the causes; 6
cases of Hereditary Spherocytosis, 4 of Autoimmune Hemolytic Anemia, 3 of Paroxysmal
Nocturnal Hemoglobinuria, 2 of Hemolytic Transfusion Reaction, 2 of Hemolytic Uremic
Syndrome. Also noted 7 cases of unknown etiology.
2) Age distribution turned out to be more cases of adult than children, ie, cases under
the age of 14 were 11, cases between 15 and 29 of age were 9 and 4 were over 30. No
specific sex distribution between the patients.
3) Anemia was the most prominent physical sign, which occupied 95.8%. Others were
62. 5% of hepatomegaly, 58.3% of jaundice, 50% of splenomegaly in order.
4) The lowest patients. initial Hb was 3.8g% in AIHA and relatively high level of 7.
45g% was noted in HS. Though initial mean reticulocyte count was highest in PNH to
34. 96%, no significance could be found during the course of each disease.
5) Mean values of WBC and platelet counts were in normal level.
6) Serum iron & total iron binding capacity were normal except 3 cases of PNH who
showed iron deficiency state.
7) Mean plasma Hb level of 11 cases was elevated to 53.l4㎎%, and the highest was
103.2㎎% in PNH. Mean serum LDH of 8 cases was also elevated to 1198.75 units.
8) The highest serum total bilirubin was 4.58㎎% in HS.
9) Coombs test was positive in 3 cases of AIHA and cold agglutinin test was also
positive in another 3 cases with some overlapping.
10) All the cases of PNH showed positive Ham's test and sucrose hemolysis test,
hemosiderinuria and hemoglobinuria.
11) 2 cases of HS showed positive autohemolysis test. which could be prevented by
addition of glucose.
12) RBC osmotic fragility was increased in 9 cases; 4 cases of 5 in HS. 1 of AIHA, 1
of PNH, 2 of hemolytic uremic syndrome, 1 of H.A. of unknown etiology.
13) one case of warm antibody induced AIHA who was positive in Ham's test and
showed spherocytosis, positive autohemolysis test and increased RBC osmotic fragility
could be differentiated from PNH and HS by the special tests.
14) All the cases of 23 who were performed bone marrow examination showed
erythroid hyperplasia. Mean M/E ratio was reversed to 1:2.6.
15) Splenectomy in one case of HS and combined splenectomy with prednisolone in
one of AIHA gave improvement. Androgen or Testosterone was administered in patients
with PNH.
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