ObjectiveTo summarize key points of diagnosis for hemolytic crisis by analyzing clinical data of children with acute hemolytic anemia(AHA),aimed to supply clinical diagnosis with evidences.MethodsCauses,manifestations,laboratory findings,therapy and prognosis of 83 children with AHA were studied retrospectively.ResultsClinical features varied with degree of hemolysis,fatigue,severe pallor,anhelation,vomiting, dark urine(tea colored) and blowing murmur of heart were major signs and physical findings in patients with Hb lower than 70 g/L.There were no significant differences for serum potassium,CO2CP,ALT and reticulocyte count among various degrees of hemolysis (P＜0.05),but WBC,BUN and LDH increased significantly as deterioration of hemolysis especially for the patients with Hb lower than 70 g/L.ConclusionKey points of diagnosis for hemolytic crisis are suggested: (1) hemolytic anemia is demonstrateded;(2) Hb was lower than 70 g/L and severe pallor,fatigue,vomiting,dark urine,anhelation,heart murmur and renal dysfunction were showed.Hb was lower than 60 g/L and at least five of above manifestations.A diagnosis of hemolytic crisis is highly suspected if a patient presents with condition (1) and (2);(3) A diagnosis of hemolytic crisis should be made if the patient has one of following characteristics such as high fever,acute abdominal pain,hypotension,unconsciousness,convulsion,heart failure or acute renal failure.(4)Any patient with Hb≤30 g/L should be diagnosis as hemolytic crisis,no matter how is the manifestations.(5) WBC 18 109 and serum LDH 800IU/L are useful for the diagnosis of hemolytic crisis.

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