PS shows signs of oxidant hemolysis, but not the specific cause of the oxidant hemolysis
Unstable Hb undergo spontaneous oxidative denaturation, which can be further accelerated by oxidative stresses (e.g., fever, infection, drugs).
G6PD deficiency limits the production of glutathione and renders deficient RBCs sensitive to oxidative stress. Depending on the mutation, hemolysis- intermittent only or chronic.
Hydroxylamine- dapsone metabolite , can cause oxidant hemolysis in patients both with and without G6PD deficiency
Signs of oxidant hemolysis-
Eccentrocytes (blister cells) - denatured Hb that aggregates/pools at one corner + empty rim of cytoplasm.
Bite cells- result of splenic pitting of RBC inclusions, like aggregates of denatured Hb or Heinz bodies.
Heinz bodies- during the acute hemolytic phase but rapidly removed (pitted) by spleen within 1 day after stopping of hemolysis.