Anemia, hemolytic

A condition in which red blood cells are destroyed faster than they can be made

Hemolytic anemia
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Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Fatigue, pallor, shortness of breath, jaundice
Complications	Heart failure, gallstones
Onset
Duration
Types	N/A
Causes	Autoimmune disorders, genetic disorders, infections, medications
Risks	N/A
Diagnosis	Blood test, Coombs test, bone marrow biopsy
Differential diagnosis	N/A
Prevention	N/A
Treatment	Depends on the cause; may include corticosteroids, immunosuppressants, blood transfusions
Medication	N/A
Prognosis	N/A
Frequency
Deaths	N/A

Hemolytic anemia is a form of anemia due to the abnormal breakdown of red blood cells (RBCs), either in the blood vessels (intravascular hemolysis) or elsewhere in the body (extravascular hemolysis). This condition can lead to a variety of symptoms and complications, depending on the severity and underlying cause.

Pathophysiology

Hemolytic anemia occurs when the destruction of red blood cells outpaces their production in the bone marrow. Normally, RBCs have a lifespan of about 120 days, but in hemolytic anemia, this lifespan is significantly reduced. The breakdown of RBCs releases hemoglobin into the bloodstream, which can lead to jaundice and other complications.

Causes

Hemolytic anemia can be caused by a variety of factors, which can be broadly categorized into intrinsic and extrinsic causes:

• Intrinsic causes: These are usually hereditary and include conditions such as sickle cell anemia, thalassemia, and hereditary spherocytosis.
• Extrinsic causes: These are often acquired and include autoimmune disorders (e.g., autoimmune hemolytic anemia), infections (e.g., malaria), certain medications, and mechanical causes (e.g., prosthetic heart valves).

Symptoms

The symptoms of hemolytic anemia can vary but often include:

• Fatigue and weakness
• Pallor
• Shortness of breath
• Jaundice (yellowing of the skin and eyes)
• Dark-colored urine
• Enlarged spleen (splenomegaly)

Diagnosis

The diagnosis of hemolytic anemia typically involves a combination of laboratory tests and clinical evaluation. Key tests include:

• Complete blood count (CBC) to assess the levels of RBCs, hemoglobin, and hematocrit.
• Reticulocyte count to evaluate bone marrow response.
• Peripheral blood smear to examine the shape and size of RBCs.
• Coombs test to detect antibodies against RBCs.
• Bilirubin levels to assess the degree of hemolysis.

Treatment

Treatment of hemolytic anemia depends on the underlying cause. Options may include:

• Corticosteroids to reduce immune-mediated destruction of RBCs.
• Immunosuppressants for severe autoimmune cases.
• Blood transfusions to manage severe anemia.
• Splenectomy in cases where the spleen is excessively destroying RBCs.
• Treating the underlying cause, such as discontinuing an offending medication or treating an infection.

Prognosis

The prognosis for hemolytic anemia varies widely depending on the cause and severity of the condition. Some forms, such as those caused by infections or medications, may resolve with treatment, while others, like genetic disorders, may require lifelong management.

Also see

• Anemia
• Autoimmune hemolytic anemia
• Sickle cell disease
• Thalassemia
• Jaundice