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4 out of 6

Decreased osmotic fragility is seen in (select two option) (PGI Nov 2010)

A Hereditary spherocytosis

B Sickle cell ds

C Autoimmune hemolytic anemia

D Thalassemia

Ans. B

Sickle cell ds, D. Thalassemia

1. Investigations

a. Presence of hemolytic state MCV , MCHC

b. Increased osmotic fragility of RBCs:

c. Presence of spherocytes in the blood film

Extra Edge: (Ref. Hari- 18th ed., Pg.- 875)

A characteristic feature is an increase in MCHC: this is the only condition in which an increased MCHC is seen.

In most cases, the diagnosis can be made on the basis of red cell morphology and of a test for osmotic fragility, a modified version of which is called the "pink test.

2. Causes of increased osmotic fragility

a. H. spherocytosis

b. Autoimmune hemolytic anaemia

c. Hemolytic disease of new born

d. Malaria

e. Severe PK deficiency

3. Causes of Decreased osmotic fragility is seen in : a. Sickle cell disease b. Thalassemia