Acquired hemolytic anemia can be divided into immune and non-immune mediated forms of hemolytic anemia. Immune Immune mediated hemolytic anaemia (direct Coombs test is positive) Autoimmune hemolytic anemia Warm antibody autoimmune hemolytic anemia Idiopathic Systemic lupus erythematosus (SLE) Evans' syndrome (antiplatelet antibodies and hemolytic antibodies) Cold antibody autoimmune hemolytic anemia Idiopathic cold hemagglutinin syndrome Infectious mononucleosis and mycoplasma (atypical) pneumonia Paroxysmal cold hemoglobinuria (rare) Alloimmune hemolytic anemia Hemolytic disease of the newborn (HDN) Rh disease (Rh D) ABO hemolytic disease of the newborn Anti-Kell hemolytic disease of the newborn Rhesus c hemolytic disease of the newborn Rhesus E hemolytic disease of the newborn Other blood group incompatibility (RhC, Rhe, Kidd, Duffy, MN, P and others) Alloimmune hemolytic blood transfusion reactions (i.e., from a non-compatible blood type) Drug induced immune mediated hemolytic anemia Penicillin (high dose) Methyldopa Non-immune Non-immune mediated hemolytic anemia (direct Coombs test is negative) Drugs (i.e., some drugs and other ingested substances lead to hemolysis by direct action on RBCs, e.g., ribavirin ) Toxins (e.g., snake venom; plant poisons such as aesculin) Trauma Mechanical (from heart valves, extensive vascular surgery, microvascular disease, repeated mechanical vascular trauma) Microangiopathic hemolytic anemia (a specific subtype with causes such as TTP, HUS, DIC and HELLP syndrome) Infections (Note: Direct Coombs test is sometimes positive in hemolytic anemia due to infection) Malaria Babesiosis Sepsis Membrane disorders Paroxysmal nocturnal hemoglobinuria (rare acquired clonal disorder of red blood cell surface proteins) Liver disease Drug induced hemolysis Drug induced hemolysis has large clinical relevance. It occurs when drugs actively provoke red blood cell destruction. It can be divided in the following manner: Drug-induced autoimmune hemolytic anemia Drug-induced nonautoimmune hemolytic anemia A total of four mechanisms are usually described, but there is some evidence that these mechanisms may overlap. References External links