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Hemolytic crisis
Definition:
Hemolytic crisis is the rapid destruction of red blood cells (hemolysis) beyond that for which the body can compensate by increasing blood cell production.

Alternative Names:
Hemolysis - acute

Considerations:

Rapid destruction of red blood cells (RBCs) can be triggered in a wide variety of conditions, both because of defects within the cell and abnormalities in the blood environment. These conditions are called hemolytic anemias.

Anemia is present because there is always some degree of hemolysis with resulting decreased hematocrit. In some hemolytic anemias, such as glucose-6-phosphate dehydrogenase deficiency (G6PD), exposure to certain chemicals can synchronize the destruction of the RBCs.

Massive RBC destruction causes an acute (and often profound) anemia because the body is unable to compensate by making enough blood cells to replace those destroyed. This can also cause overloading of the kidneys with free hemoglobin. Hemolytic crises in G6PD can be fatal.
Common Causes:
Home Care:
Consult your health care provider.
Call your health care provider if:
  • Your urine appears red, red-brown, or brownish (tea-colored) in color. (This is caused by the presence of hemoglobin in the urine.)
  • You experience fatigue, pale skin, or other symptoms of anemia -- especially if they appear to be worsening or if new symptoms begin to develop.
  • You notice a decrease in the volume of urine produced.
What to expect at your health care provider's office:
Emergency interventions will be initiated if necessary. This may include hospitalization, administration of oxygen, blood transfusions, and other treatments.

When the condition is stable, the medical history will be obtained and a physical examination will be performed.

Medical history questions documenting hemolytic crisis in detail may include:
  • Time pattern
    • When did you first notice symptoms?
  • Quality
    • What symptoms did you notice?
  • Medical history
    • Do you have a known medical history of a hemolytic anemia, G6PD deficiency, or kidney disorder?
    • Have you ever experienced this before?
      • Was hospitalization required?
      • What was the treatment?
      • What was the outcome?
  • Other
    • What other symptoms are present?
The physical examination may occasionally show enlargement of the spleen (splenomegaly).

Diagnostic tests may include: After seeing your health care provider:
You may want to add a diagnosis related to a hemolytic crisis to your personal medical record.
Review Date: 10/18/2001
Reviewed By: Rebecca Elstrom, M.D., Division of Hematology-Oncology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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