Excessive hemolysis can be seen as early as the first 24 hours of life, causing early and prolonged neonatal jaundice . Hypoplastic crisis , due to viral-induced bone marrow suppression, is another common manifestation of this disease. Parvovirus-like viruses are particularly common etiologies. Treatment with blood transfusion may be necessary in cases of acute hemolysis or prolonged hypoplastic crises. Osmotic fragility test measures the increased sensitivity of red cells to hypotonic saline.
Splenectomy is the treatment of choice which results in prolonging the spherocytes life span.
This procedure is usually deferred until after 5 year of age, because of the risk of post-splenectomy sepsis. Vaccination and prophylaxis antibiotic are mandatory in splenectomized patients. She was noticed to be pale and irritable two weeks prior to referral. Her physical examination was remarkable for pallor, but no jaundice. Coombs tests were negative.