Hemolytic anemia

Red blood cells, sickle and pappenheimer

Hemolytic anemia

Definition:

Hemolytic anemia is a condition of an inadequate number of circulating red blood cells (anemia), caused by premature destruction of red blood cells. There are a number of specific types of hemolytic anemia which are described individually.

Alternative Names:

Anemia - hemolytic

Causes, incidence, and risk factors:

Hemolytic anemia occurs when the bone marrow is unable to compensate for premature destruction of red blood cells by increasing their production. When the marrow is able to compensate, anemia does not occur.

There are many types of hemolytic anemia, which are classified by the location of the defect. The defect may be in the red blood cell itself (intrinsic factor), or outside the red blood cell (extrinsic factor).

Causes of hemolytic anemia include infection, certain medications, autoimmune disorders, and inherited disorders. Types of hemolytic anemia include:

Sickle cell anemia
Paroxysmal nocturnal hemoglobinuria
Hemoglobin SC disease
Hemolytic anemia due to G6PD deficiency
Hereditary elliptocytosis
Hereditary spherocytosis
Hereditary ovalocytosis
Idiopathic autoimmune hemolytic anemia
Non-immune hemolytic anemia caused by chemical or physical agents
Secondary immune hemolytic anemia
Sickle thalassemia

Symptoms:

Signs and tests:

These are tests for hemolysis (red blood cell destruction). There are specific tests which identify the specific types of hemolytic anemia. They are performed after hemolysis has been established.

Elevated indirect bilirubin levels
Low serum haptoglobin
Hemoglobin in the urine
Hemosiderin in the urine
Increased urine and fecal urobilinogen
Elevated absolute reticulocyte count
Low red blood cell count and hemoglobin
Elevated serum LDH

Direct measurement of the red cell life span by isotopic tagging techniques shows a decreased life span.

This disease may also alter the following test results depending on the specific cause:

Treatment:

Treatment depends upon the type and cause of the hemolytic anemia. Folic acid, iron replacement, and corticosteroids may be used. In emergencies, transfusion of blood may be necessary.

Expectations (prognosis):

The outcome depends upon the type of hemolytic anemia.

Complications:

The complications vary with the specific type of hemolytic anemia. Severe anemia can cause cardiovascular collapse. Severe anemias can aggravate pre-existing heart disease, lung disease, or cerebrovascular disease.

Call for an appointment with your health care provider if symptoms of hemolytic anemia develop.

Prevention:

There is no known prevention for hemolytic anemia.

Review Date: 10/8/2001
Reviewed By: Rebecca Elstrom, M.D., University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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