Diagnosis and treatment of childhood hemolytic anemia (hemolytic anemia) Diagnostic points Congenital hemolytic anemia often has a clear family history and hepatosplenomegaly, including hereditary spherocytosis and thalassemia with a chronic hemolytic process; congenital G-6PD deficiency and acquired AIHA often have a rapid onset, often with a sharp drop in Hb and dark urine (hemoglobinuria) and other characteristic manifestations. Congenital G-6PD deficiency is most often seen in infants and children who suddenly develop the disease after consuming fava beans, while AIHA is most often preceded by a history of prodromal viral infection. The emergency anti-human globulin test is a simple, rapid and effective differential diagnostic measure that helps to confirm the diagnosis and provide emergency treatment. The severity of chronic hemolytic anemia varies widely, and mild cases do not require treatment. In severe spherocytosis, splenectomy can be performed after the age of 6 years, which is very effective. Thalassemia major requires allogeneic hematopoietic stem cell transplantation. In the absence of these treatments, blood transfusions are required to correct moderate or severe anemia, maintain growth and improve quality of life. Long-term transfusion will lead to iron overload in the body and damage the function of important organs, requiring treatment with iron removal agents. Acute anemia can be life-threatening, and emergency blood transfusion is an important measure. In congenital G-6PD deficiency, transfusion of normal human blood is sufficient, but AIHA requires blood centers to provide “washed red blood cells” to avoid aggravating hemolysis. In addition, fluid transfusion and correction of metabolic acidosis are required to maintain blood circulation and renal function, and adequate glucocorticoid therapy is required for AIHA, while a lifelong ban on fava beans and their products is required for congenital G-6PD deficiency.