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Thrombotic microangiopathy (TMA) is related to a histological lesion in arterioles and capillaries, characterized by thickening and inflammation of the vascular wall, detachment of endothelial cells, enlargement of the subendothelial space with accumulation of proteins and cell lysis material, and the presence of platelet thrombi that occlude the vascular lumen. There are two clinical entities with primary thrombotic microangiopathy lesions: thrombotic thrombocytopenic purpura and hemolytic uremic syndrome. Thrombotic thrombocytopenic purpura is related to a deficit or dysfunction of disintegrin and metalloproteinase activity, which splits the bond of von Willebrand factor, a protein involved in the clotting process. Clinically it is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and increased serum lactate dehydrogenase. On contrast, the hemolytic uremic syndrome is defined by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury, and can be classified as typical and atypical. The typical hemolytic uremic syndrome is associated with the prodrome of diarrhea after infection with Shiga toxin-producing Escherichia coli, while atypical HUS is associated with abnormalities in the alternative complement pathway, Streptococcus pneumoniae infections, systemic lupus erythematosus, disorders of the cobalamin C metabolism, among others. [ABSTRACT FROM AUTHOR]

BACKGROUND: Hemolytic disease of the newborn (HDN) refers to the perinatal effects of fetal maternal erythrocyte isoimmunization that leads to an immune reaction allowing lysis of these cells. OBJECTIVE: To describe the clinical and epidemiological profile of patients with HDN treated in a university hospital during the 2014-2018 period. Materials and methods: Observational, descriptive, retrospective, cross-sectional study that included neonates with EHRN and their mothers. A non-probabilistic sampling of consecutive cases was carried out. RESULTS: 216 newborns diagnosed with HDN were included, with a mean gestational age of 38.1±2.18 weeks. Blood group A predominated in the neonate with 62.5% and group O in the mother with 88.4%. Regarding the clinical presentation, 85.1% of the patients presented jaundice, 86.4% received phototherapy and only 1.4% had complications. CONCLUSION: The HDN in this study shows jaundice as the most frequent sign, allowing a diagnosis generally in the first 48 hours postpartum and an effective and timely intervention. It was identified that a large part of the population required phototherapy and red blood cell transfusions for their treatment to avoid later complications. [ABSTRACT FROM AUTHOR]

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Hemolytic anemia is a group of disorders in which there is an early destruction of the red blood cell. The group of clinical manifestations derived from this hemolysis is known as hemolytic syndrome, in which the results of the peripheral lamina vary according to the cause of the hemolysis, reason why this examination constitutes a valuable orientation. This bibliographical review addresses the results of the peripheral blood smear study in different causes of hemolytic anemia and describes the morphological and semi-quantitative alterations of peripheral blood cells with the aim of providing a guideline that suggests an early diagnosis due to the seriousness of some conditions of hemolytic syndrome. [ABSTRACT FROM AUTHOR]

Introduction: Sickle cell anemia is a structural hemoglobinopathy of genetic origin, characterized by the presence of sickle hemoglobin. Abnormal hemoglobin is unstable and tends to polymerize and can occlude the microcirculation. Also, it produces both acute and chronic multi system manifestations associated with an increased risk of infection. Objective: To describe the information of the exposed topic highlighting the most relevant aspects such as diagnosis and treatment. Methodology: A literature review with electronic search was carried out in the following databases: PubMed, MEDLINE, Medscape, Scopus; different types of articles were included that addressed sickle cell anemia in pediatrics such as original articles, reviews of topics and management. Results: A review of 22 articles was obtained which describes the subject of sickle cell anemia, guidelines and treatments based on the management and control of symptoms. It is evident that the use of transcranial Doppler ultrasound and transfusions proved to be preventive strategies or effective treatments for the complications related to this pathology in children. Conclusions: In Colombia, the prevalence of the pathology is not established yet. On the other hand, the main manifestations are related to complications of vaso-occlusion in different organs and functional asplenia which predisposes to infectious conditions. [ABSTRACT FROM AUTHOR]

A 55-year-old female patient, born in Ayacucho, with a history of dermatomyositis for 3 years, who received irregular treatment with prednisone. Two months prior to admission, she presented with autoinmune hemolytic anemia and idiopathic thrombocytopenic purpura. The patient received methylprednisolone pulse therapy and packed red blood cells transfusions. Upon admission, she was drowsy, with a poor overall status, marked weight loss, dehydration, with presence of livedo reticularis in her lower extremities, and onychodystrophy and onycholysis on the toes of both feet. Western blot test was positive for human T-lymphotropic virus type 1 (HTLV-1). The patient evolved with recurrent hypoglycemia. Therefore, we report a case of dermatomyositis and Evans syndrome in the context of an HTLV-1 infection. [ABSTRACT FROM AUTHOR]

Introduction: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease of unknown cause, great clinical heterogeneity and variable prognosis. Case report: A 42-yearold woman with a history of Evans' syndrome, urticarial vasculitis, chronic consuming of anovulatory; goes to Almanzor Aguinaga Asenjo National Hospital (HNAAA) with edema in left foot, positive Hollow and Homans signs. Eco-Doppler suggested Deep Vein Thrombosis (DVT), antibodies to Antiphospholipid Syndrome (APS) positive, APS diagnosed. Conclusion: The study of SLE detected: positive ANA, negative Anti-DNA-dc and Anti-Sm; Renal Biopsy revealed Lupus Nephritis I, SLE was diagnosed. [ABSTRACT FROM AUTHOR]

Objective: To describe the clinical characteristics of patients with autoimmune hemolytic anemia in a private clinic in the city of Medellin. Materials and methods: Retrospective descriptive study of seven cases of AHA that were treated at private clinic in the city of Medellin (Colombia) between 2005 and 2010. The information was taken from the patients' clinical history. Results: 6 of the 7 cases were women, the median age was 47 years (minimum 21 and maximum 74). The most frequent concomitant diseases were SLE and infectious with 3 cases each one. The therapy is based primarily on the use of glucocorticoids with 4 cases found and never resorted to biological therapy. Two patients required change of its treatment. Conclusion: This study shows the clinical and demographic findings of a small number of adult cases with AHA. National studies are needed greater geographic coverage to help establish the true incidence of this disease and describe the main clinical and epidemiological characteristics. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Hereditary spherocytosis is a common cause of hemolytic anemia due to an alteration of the erythrocyte membrane. Affected patients can remain asymptomatic, with a minimum hemolysis, or develop a severe hemolytic anemia. It is transferred as an autosomal dominant disease, less frequent as an autosomal recessive one, or with no medical history in the family. CASE REPORT: 3 month-old infant, with a medical history of neonatal ictericy lengthy so far, consultation at San Ignacio polyclinic because of a postprandial regurgitation, a hemogram is carried out by presenting intense paleness and ictericy, detecting severe anemia and indirect hyperbilirubinemia. It is decided to hospitalize him into Herminda Martin Clinic Hospital, being hypoactive, with no other symptoms. 50 cc red corpuscles are transfused, progressing favorably. During hospitalization it is found out the medical history of a cousin who was splenectomized due to hemolytic anemia symptoms recurring for 5 years. It is decided the discharge with a folic acid treatment and an interconsult with a hematologist. DISCUSSION: Although the hereditary spherocytosis is the congenital hemolytic anemia more frequent in Chile, its diagnosis turns more complicated for an unknown medical history in the family, or if it does not present reticulocytosis nor splenomegaly (as in this case), which leads to think of other causes of anemia. Because of that it was very important the medical history of the family known after his admission into the hospital, because it directed towards a diagnosis that in this case did not have a typical presentation. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Hereditary spherocytosis is a common cause of hemolytic anemia due to an alteration of the erythrocyte membrane. Affected patients can remain asymptomatic, with a minimum hemolysis, or develop a severe hemolytic anemia. It is transferred as an autosomal dominant disease, less frequent as an autosomal recessive one, or with no medical history in the family. CASE REPORT: 3 month-old infant, with a medical history of neonatal ictericy lengthy so far, consultation at San Ignacio polyclinic because of a postprandial regurgitation, a hemogram is carried out by presenting intense paleness and ictericy, detecting severe anemia and indirect hyperbilirubinemia. It is decided to hospitalize him into Herminda Martin Clinic Hospital, being hypoactive, with no other symptoms. 50 cc red corpuscles are transfused, progressing favorably. During hospitalization it is found out the medical history of a cousin who was splenectomized due to hemolytic anemia symptoms recurring for 5 years. It is decided the discharge with a folic acid treatment and an interconsult with a hematologist. DISCUSSION: Although the hereditary spherocytosis is the congenital hemolytic anemia more frequent in Chile, its diagnosis turns more complicated for an unknown medical history in the family, or if it does not present reticulocytosis nor splenomegaly (as in this case), which leads to think of other causes of anemia. Because of that it was very important the medical history of the family known after his admission into the hospital, because it directed towards a diagnosis that in this case did not have a typical presentation. [ABSTRACT FROM AUTHOR]