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CASE: A 10-month-old infant, past few weeks have been progressively pale…

- - - - Precipitation in RBC precursors with bone marrow
        
        Premature death of RBC precursors
        
        Ineffective erythtopoiesis
        
        Decreased RBC
        
        Increased reticulocyte count
        
        Elevated lactate dehydrogenase
        
        Bone marrow dysfuction
    - - Impaired beta globulin chain synthesis and excess alpha chains
        
        Abnormal erythroblast
        
        Abnormal erythroblast enter circulation
        
        Precipitation of alpha globulin aggregates with membrane damage
        
        Extravascular hemolysis in spleen
        
        Abnormal erythroblast dies in bone marrow
        
        Defective erythropoiesis
        
        Anemia
        
        Tissue hypoxia
        
        1 more item...
- - - - Small size and weight. Below 3rd centile
        
        Yellowish discolouration of eyes
        
        Abnormal RBC in spleen is destroyed by macrophages and results in heme formation
        
        More heme = more bilirubin production. Excessive bilirubin released in blood and leads to hyperbilirubinemia
      - Due to consumption of abnormal RBCs by spleen
- - - - High total bilirubin
      - High LDH
  - - - Increased red cell destruction
      - Decrease red cell production
      - Blood loss (excessive)