Hemolytic anemia may occasionally occur following envenomation by the brown recluse spider (Loxosceles reclusa).
Patient selection: hemolytic anemia
Clinical features:
(1) history of, or clinical evidence of, a brown recluse spider bite
(2) red blood cells may be Coombs-positive or Coombs-negative
(3) exclusion of other causes of hemolytic anemia (autoimmune disease, cold agglutinin disease, drugs, etc)
The onset of the hemolytic anemia may be delayed several days after the bite.
The hemolyhsis may be severe and/or refractory.
A patient may develop acute renal failure if the envenomation is complicated by hemolysis and/or rhabdomyolysis.
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Specialty: Hematology Oncology, Toxicology
