ANEMIA, HEMOLYTIC

General Information

DEFINITION--Anemia due to the premature destruction of red blood cells (a process known as hemolysis). Bone marrow cannot produce red blood cells fast enough to compensate for those being destroyed. These anemias can be acquired (develop over time) or congenital (present at birth).

BODY PARTS INVOLVED--Blood; bone marrow; spleen.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Fatigue.
• Shortness of breath.
• Irregular heartbeat.
• Jaundice (yellow skin and eyes, dark urine).
• Enlarged spleen.

CAUSES

• Inherited disorder, such as hereditary spherocytosis, G6PD deficiency, sickle-cell anemia or thalassemia. One inherited variety, favism, is common in Greece; hemolysis occurs after eating a type of bean.
• Antibodies produced by the body to fight infections, that for unknown reason attack red blood cells. This response is sometimes triggered by blood transfusions.
• Use of medications, including non-prescription drugs, that damage red blood cells.

RISK INCREASES WITH

• Family history of hemolytic anemia.
• Use of any medication.

HOW TO PREVENT

• Don't take any medicine that has previously triggered hemolytic anemia.
• Seek genetic counseling before having children if you have a family history of hemolytic anemia (inherited forms).
• Some types may be preventable by avoidance of the drugs or foods that precipitate hemolysis.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies, including blood count, examination of bone marrow, and measurement with radioactive chromium of red cell survival.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization for transfusions during a hemolytic crisis.
• Surgery to remove an enlarged spleen (sometimes).
• Treatment is individualized depending on the specific hemolytic problem.

POSSIBLE COMPLICATIONS

• Excessive spleen enlargement, which increases destruction of red blood cells.
• Pain, shock and serious illness caused by hemolysis (red blood cell destruction).
• Gallstones.

PROBABLE OUTCOME--

• If hemolytic anemia is acquired, it can usually be cured when the cause, such as a drug, is removed. Sometimes the spleen is removed surgically.
• If hemolytic anemia is inherited, it is currently considered incurable. However, symptoms can be relieved or controlled. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.

How To Treat

GENERAL MEASURES----If removal of the spleen is required, see Spleen Removal in Surgery section for an explanation of surgery and postoperative care.

MEDICATION--Your doctor may prescribe:

• Immunosuppressive drugs to control the antibody response.
• Medication to reduce pain. For minor discomfort, you may use non-prescription drugs such as acetaminophen.

ACTIVITY--After treatment, resume normal activities as soon as possible.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of hemolytic anemia.
• The following occurs during treatment: Fever. Cough. Sore throat. Swollen joints. Muscle aches. Bloody urine. Signs of infection in any part of the body (redness, pain, swelling, fever).
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.