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106 Hemolytic Anemias and Anemia Due to Acute Blood Loss
Lucio Luzzatto

	Figure 106-1  RBC metabolism. The Embden-Meyerhof pathway (glycolysis) generates ATP for energy and membrane maintenance. The generation of NADPH maintains hemoglobin in a reduced state. The hexose monophosphate shunt generates NADPH that is used to reduce glutathione, which protects the red cell against oxidant stress. Regulation of...
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	Figure 106-2  Diagram of red cell membrane-cytoskeleton. (For explanation see text.) (From N Young et al: Clinical Hematology. Copyright Elsevier, 2006; with permission.)
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	Figure 106-3  Peripheral blood smear from patients with membrane-cytoskeleton abnormalities. A. Hereditary spherocytosis. B. Hereditary elliptocytosis, heterozygote. C. Elliptocytosis, with both alleles of the α-spectrin gene...
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	Figure 106-4  Diagram of redox metabolism in the red cell. G6P, glucose 6-phosphate; 6PG, 6-phosphogluconate; G6PD, glucose 6-phosphate dehydrogenase; GSH, reduced glutathione; GSSG, oxidized glutathione; Hb, hemoglobin; MetHb, methemoglobin; NADP, nicotinamide adenine -dinucleotide phosphate; NADPH, reduced nicotinamide adenine dinucleotide...
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	Figure 106-5  Epidemiology of G6PD deficiency throughout the world. The different shadings indicate increasingly high levels of prevalence, up to about 20%; the different colored symbols indicate individual genetic variants of G6PD, each one having a different mutation. [From L Luzzatto et al, in C Scriver et al (eds):...
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	Figure 106-6  Peripheral blood smear from a 5-year-old G6PD-deficient boy with acute favism.
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	Figure 106-7  Mechanism of antibody-mediated immune destruction of red cells. (From N Young et al: Clinical Hematology. Philadelphia, Elsevier, 2006; with permission.)
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	Figure 106-8  Consecutive urine samples from a patient with paroxysmal nocturnal hemoglobinuria (PNH). The variation in the severity of hemoglobinuria within hours is probably unique to this condition.
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	Figure 106-9  The complement cascade and the fate of red cells.A.  Normal red cells are protected from complement activation and subsequent hemolysis by CD55 and CD59. These two proteins, being GPI-linked, are missing from the surface of PNH red cells as a result of a somatic...
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	Figure 106-10  Therapeutic efficacy of an anti-C5 antibody on the anemia of paroxysmal nocturnal hemoglobinuria. (From P Hillmen et al: N Engl J Med 355:1233, 2006; with permission.)
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