Spectrum of haemolytic anaemias in Punjab, North India.

Between July 1974 and June 1978 the diagnosis of haemolytic anaemia was made in 267 patients. Thalassaemia major was the leading cause (40-50%) every year except in 1977, when a sharp rise in drug induced haemolysis in G-6-PD deficient patients (61.3%) was encountered. This was possible due to an increase in incidence of vivax malaria and the use of anti-malarial drugs in that year. Abnormal haemoglobins were noted in 9.7% of the total number of patients. Hereditary spherocytosis, autoimmune haemolytic anaemias and paroxysmal nocturnal haemoglobinuria formed a minor cause. Others included copper sulphate poisoning, snake bite, hornet sting and Plasmodium falciparum infection.