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

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:

Uric acid

TIBC

RBC indices

Protein electrophoresis - serum

Potassium test

Platelet count

Peripheral smear

Leukocyte alkaline phosphatase

Serum iron

Hematocrit

Ferritin

Febrile or

cold agglutinins

Donath-Landsteiner test

Coombs' test, indirect

Coombs' test, direct

CBC

Blood differential

AST

24 hour

urine protein

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.