EVANS E R
Calif Med. 1951 Oct;75(4):271-5.
Classification of the varieties of hemolytic anemia is based upon whether hemolysis is due to inherent defects within the erythrocyte or to extracellular factors. CONFIRMATION OF DIAGNOSIS IN CASES IN WHICH THE DISEASE IS CLINICALLY SUSPECTED IS MADE UPON THE BASIS OF THE FOLLOWING LABORATORY DATA: Hyperbilirubinemia giving an indirect van den Bergh reaction, observation of typical factors in a smear of the blood, a reactive bone marrow, increased urobilinogen in stools and urine, and absence of bilirubinuria. Differentiation of the different types depends upon determination of altered fragility of erythrocytes as indicated by tests of resistance to heat, acid, and mechanical and osmotic stimuli, and upon the identification of an antibody. The importance of detecting antibodies demonstrable in acid serum is mentioned. In a majority of cases, acquired hemolytic anemia is caused by antibodies, malignant disease, or toxic agents.
溶血性贫血的分类是基于溶血是由于红细胞内在缺陷还是细胞外因素所致。对于临床疑似病例，诊断的确立基于以下实验室数据：高胆红素血症导致间接范登堡反应、血涂片观察到典型因素、骨髓反应性增生、粪便和尿液中尿胆原增加以及无胆红素尿。不同类型的鉴别取决于通过耐热、耐酸、耐机械和渗透刺激试验所显示的红细胞脆性改变的测定，以及抗体的鉴定。文中提到了检测酸溶血试验中可证实的抗体的重要性。在大多数情况下，获得性溶血性贫血是由抗体、恶性疾病或毒性物质引起的。
