Mechanisms of Hemolysis — The Minimal Red-Cell Defect

THE exact cause of hemolysis in many hemolytic disorders remains obscure or incompletely established; however, premature destruction of circulating red cells appears to occur under three general conditions: abnormalities of hemoglobin influencing the flow properties of the red cells (e.g., aggregation of sickle hemoglobin or precipitation of Heinz bodies); exposure of red cells to inordinate physical trauma in the circulation (e.g., microangiopathic hemolytic anemias); and abnormalities associated with the red-cell membrane (Table 1).Red cells may undergo lysis in the intravascular space, or they may be destroyed in the reticuloendothelial system (RES). Intravascular lysis is uncommon. It usually occurs with . . .