MAHA is a nonimmune condition characterized by hemolytic anemia either due to abnormalities in the microvasculature or to intravascular devices that lead to fragmentation of the red blood cells. When MAHA is combined with thrombocytopenia, it is referred to as thrombotic microangiopathy (TMA). Pathologists may get requisitions for peripheral blood smear review that say “rule out MAHA”, explains hematopathologist Dr. Vandita Johari.

While these may appear like a simple question, these patients tend to be complex and have multiple comorbid conditions and a clear understanding of the laboratory findings and approach to differential diagnosis of this condition is required to provide an appropriate answer. Dr. Johari lead the development of a case-based course on this topic as part of the CAP’s Clinical Pathology Improvement Program—or CPIP (https://capatholo.gy/2zdW1rR).