What is the pathogenesis of MAHA?
a. Microthrombi and fibrin formed on damaged endothelial cells trap and break red cells.
b. Chemicals or heat destroy red blood cells (RBCs).
c. The spleen sequesters red cells in an attempt to remove abnormal inclusions.
d. Antibodies that activate complement are formed and destroy the red cell membrane.
ANS: A
As red cells pass through fibrin deposits that have been abnormally formed inside the lumen of blood vessels, they are fragmented as the force of blood flow forces them through the fibrin. Red cell fragments may also be formed by turbulence of red cells as they pass over damaged endothelial cells that line the blood vessels.
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