Red blood cells have an important function to deliver oxygen from the lungs to the heart and all body tissues.
Hemolytic Anemia Definition
Red blood cells have an important function to deliver oxygen from the lungs to the heart and all body tissues. Bone marrow functions to produce red blood cells. When the destruction of red blood cells is faster than the bone marrow’s ability to produce these cells, the condition is known as hemolytic anemia.
Hemolytic anemia can be extrinsic or intrinsic. Hemolytic anemia occurs through several mechanisms, such as when the spleen compresses and destroys red blood cells, or when an autoimmune reaction occurs.
The destruction of red blood cells can result from infections, tumors, autoimmune diseases, side effects of certain medications, leukemia, or lymphomas. On the other hand, hemolytic anemia can occur when the red blood cells produced by the body do not function properly.
This condition can be inherited, as in individuals with sickle cell anemia or thalassemia. In some other cases, the presence of metabolic abnormalities such as in individuals with G6PD deficiency or the presence of blood cell membrane instability can cause the condition. According to Armando Hasudungan Haemolytic Anaemia – classification (intravascular, extravascular), pathophysiology, investigations
Hemolytic Anemia Reason
Hemolytic anemia can be caused by certain types of diseases or the consumption of certain medications. Some of the causes that can underlie the occurrence of extrinsic hemolytic anemia are enlarged spleen, hepatitis, Epstein-Barr virus, typhoid fever, E. coli toxin, leukemia, lymphoma, tumors, lupus, and various other health conditions.
Hemolytic anemia is not always caused by an autoimmune disease. In some cases, this condition can be caused by taking certain types of medication.
One type of severe hemolytic anemia can occur due to getting blood transfusions with blood types that do not match. Everyone has a certain blood type (A, B, AB, or O).
When a person gets a blood transfusion with an incompatible blood type, antibodies in the body can attack the foreign red blood cells. The result of this process is the rapid destruction of red blood cells, which can be dangerous.
Therefore, it is important to check the blood group before giving a transfusion.
Hemolytic Anemia Symptoms
Because hemolytic anemia can have a variety of causes, each individual may exhibit different signs and symptoms. However, there are some signs and symptoms that can also be seen in most individuals with hemolytic anemia. Some signs and symptoms of hemolytic anemia can also mimic the signs and symptoms of anemia in general.
Some of the signs and symptoms that can appear in general anemia are:
- Pale skin
- Fatigue
- Fever
- Confusion
- Feeling dizzy
- Weakness or inability to perform physical activity
Some of the signs and symptoms that can appear in hemolytic anemia, depending on the cause, are:
- Dark urine color
- The skin and whites of the eyes (sclera) are yellowish
- Abnormal heart sounds
- Increased heart rate
- Spleen enlargement
- Enlargement of the heart
Hemolytic Anemia Diagnosis
The diagnosis of hemolytic anemia can be made based on a detailed medical interview, direct physical examination, and certain investigations. During a physical exam, the doctor can check for any skin that looks pale or yellowish.
The doctor may also examine the abdomen to evaluate for an enlarged liver or spleen. If the doctor suspects anemia, additional tests can be carried out.
Several types of investigations to determine the diagnosis of hemolytic anemia are:
- Bilirubin, which is a test to measure the level of red blood cells that are broken down by the liver
- Hemoglobin, which is a test to measure the number of red blood cells
- Liver function test
- Reticulocyte count, which is a test to measure the number of red blood cells produced by the body
If the doctor suspects that the signs and symptoms you are experiencing may be related to intrinsic hemolytic anemia, a blood sample may also be examined using a microscope to evaluate the shape and size of the red blood cells.
Other tests that can be done include a urine test to check for red blood cells. In some cases, the doctor may also recommend a bone marrow aspiration or biopsy.
Hemolytic Anemia Handling
Treatment of hemolytic anemia depends on the underlying cause of the anemia, the severity of the condition, age, health status, and several other factors.
Some of the treatment options for hemolytic anemia include:
- Blood transfusion. Blood transfusions may be given to increase the red blood cell count and replace the lost red blood cells with new ones.
- Intravenous immunoglobulin. Intravenous immunoglobulins can be given in the hospital to help inhibit the immune system that causes the destruction of red blood cells.
- If extrinsic hemolytic anemia is suspected to be due to an autoimmune cause, your doctor may consider prescribing corticosteroid treatment.
This treatment can inhibit the production of antibodies from the immune system that can damage red blood cells.
- In severe cases, it may be necessary to remove the spleen, which is the organ where red blood cells are destroyed. Removal of the spleen can slow the destruction of red blood cells.
Surgery is generally considered as an option when the patient does not respond well to corticosteroids or immunosuppressants.
Prevention
Because the causes of hemolytic anemia can vary, there are no proven methods that are completely effective in avoiding the onset of the condition.
Some types of hemolytic anemia can be prevented, such as anemia due to reactions to blood transfusions, which can be avoided by always checking the blood type compatibility between the donor and recipient before performing a blood transfusion.