Hemolytic anemia is a medical condition characterized by the accelerated destruction of red blood cells in the body, outpacing their production. This results in a decreased red blood cell count, which may manifest through symptoms including fatigue, breathlessness, lightheadedness, and abnormal heart rhythms.
Continue reading to gain further insights into hemolytic anemia, encompassing its causes, symptoms, diagnostic methods, treatment options, and prognosis for individuals affected by this condition.
What is Hemolytic Anemia?
Hemolytic anemia is a hematological condition characterized by the accelerated destruction of red blood cells, outpacing the body’s ability to produce new ones. This disorder may arise from genetic factors that predispose individuals to anemia. In some cases, individuals experience mild symptoms of hemolytic anemia that resolve following appropriate treatment. Often, healthcare professionals can effectively treat hemolytic anemia once the underlying cause is identified. However, if left unaddressed, severe cases of hemolytic anemia can lead to significant cardiovascular complications.
Hemolytic anemia may be classified as either inherited or acquired.
- Inherited hemolytic anemia occurs when the genetic predisposition for the condition is transmitted from parents to their offspring.
- Acquired hemolytic anemia is not present at birth; rather, it develops at a later stage in life.
What Are the Symptoms of Hemolytic Anemia?
Hemolytic symptoms may vary in intensity, ranging from mild to severe. They can manifest abruptly or gradually over a period of time. Common symptoms include:
- Dark urine
- Fever
- Fatigue
- Dizziness
- Confusion
- Inability to tolerate physical exertion
- Enlargement of the spleen and liver.
- Unusual pallor or diminished pigmentation of the skin
- A yellowish tint to the skin, eyes, and mouth (indicative of jaundice).
Additionally, there may be an elevated heart rate (tachycardia) and the presence of a heart murmur. It is important to note that these symptoms can resemble those of other blood disorders or medical conditions. Therefore, it is essential to consult a healthcare professional for an accurate diagnosis.
What Causes Hemolytic Anemia?
Hemolytic anemia can arise from genetic disorders that impact red blood cell function. Additionally, it may result from specific infections or occur when an individual receives a blood transfusion from a donor with an incompatible blood type.
Acquired Hemolytic Anemia
Information regarding its prevalence as well as the incidence of hemolytic anemia is scarce. However, it is worth citing that according to a 2020 study, the development of hemolytic anemia in acquired cases is relatively low, with the most frequent acquired cause being autoimmune. These are diseases that result from the immune system attacking healthy cells in the body.
Other causes of acquired hemolytic anemia include:
- Bone marrow failure
- Some diseases like certain bacterial or viral illnesses
- Receiving incompatible blood transfusion such as receiving a blood type that you are highly allergic to.
- Certain medications, in particular, dapsone which is an antimalarial medicine.
Inherited Hemolytic Anemia
Inherited hemolytic anemias represent a collection of uncommon disorders that can be classified into various categories. The predominant cause of these conditions is thalassemia, characterized by the insufficient production of hemoglobin, which leads to a reduced number of red blood cells (RBCs) in the bloodstream.
Another hereditary condition is sickle cell disease, in which red blood cells assume a crescent shape instead of their normal disc form. This abnormality causes the sickle-shaped cells to have a shorter lifespan, resulting in a decreased quantity of RBCs.
Additional inherited disorders may lead to:
- Defective proteins in red blood cell membranes: These defects can influence the structure, shape, or functionality of RBCs.
- Enzymatic deficiencies within red blood cells: A notable example is the deficiency of the glucose-6-phosphate dehydrogenase enzyme, which is crucial for safeguarding RBCs from damage.
- Impaired red blood cell production: An instance of this is congenital dyserythropoietic anemia type 2, a condition where the body fails to produce red blood cells as anticipated.
What Tests Do Healthcare Providers Use To Diagnose Hemolytic Anemia?
Based on the intensity of your symptoms, your physician will initially review your medical history with you, placing particular emphasis on your family’s medical background. They will inquire if there is a history of anemia within your family. Subsequently, your physician will ask about any medications you have been taking or specific infections that may lead to hemolytic anemia. Following this discussion, your healthcare provider will perform a physical examination to check for indications of jaundice or an enlarged spleen.
- Coombs test: Identifies autoimmune hemolytic anemia.
- Complete blood count (CBC): Evaluates the quantity and size of your blood cells.
- Reticulocyte count: Assesses immature red blood cells to evaluate bone marrow activity.
- Haptoglobin test: Measures haptoglobin levels to assess damaged red blood cells.
- LDH: Indicates heightened red blood cell destruction through enzyme analysis.
- Unconjugated bilirubin: Evaluates unprocessed bilirubin, suggesting possible red blood cell destruction.
- Peripheral blood smear: Analyzes blood cells for irregularities, assisting in diagnosis.
- Hemoglobin electrophoresis: Examines hemoglobin to evaluate its role in oxygen transport.
How is Hemolytic Anemia Treated?
The management of hemolytic anemia depends on the type of the disease and the severity of the manifestation. The main forms of intervention involve the administration of blood transfusion, medications, invasive procedures such as surgery, and changes in lifestyle.
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Blood Transfusions
Hemolytic anemia is managed through blood transfusions, especially where the patient’s red blood cell count has reached alarming low levels. This procedure also aids in raising the red blood cell count and thus aids in the distribution of oxygen in the body tissues. In autoimmune hemolytic anemia (AIHA), transfusions could be required to check the accelerated pace of destruction of the red blood cells.
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Medications
Hemolytic anemias are treated with many types of drugs depending on the kind and type of anemia. Currently, corticosteroids such as prednisone are the drugs of choice for the management of autoimmune hemolyastic anemia. These medications assist in bringing down the intensity of white blood cell’s attack on red blood cells. Other medicines that may be used to treat the condition are rituximab and cyclosporine among others.
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Surgical Intervention
Surgery may be necessary in cases of hemolytic anemia that have not responded to other forms of management. They include splenectomy which involves the removal of the spleen recommended for hereditary spherocytosis and some forms of AIHA since it limits the destruction of red blood cells. This procedure can greatly enhance the red blood cell count and the general well-being of an individual.
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Lifestyle Changes
Lifestyle changes are also important measures that can help in the management of hemolytic anemia. Some preventive measures include staying away from environmental conditions that cause temperature to drop low or certain chemicals such as prescription drugs that may cause hemolysis. Also, a proper diet involving mainly whole foods and moderation of iron intake may help with the symptoms.
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Bone Marrow Transplants
In specific instances, especially in cases of severe inherited hemolytic anemia, bone marrow transplants may be regarded as a viable treatment option. This procedure is designed to substitute abnormal or damaged hematopoietic cells in the bone marrow with healthy counterparts, thereby reinstating normal red blood cell production.
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Plasmapheresis
Plasmapheresis is a medical procedure that involves the extraction of plasma from the bloodstream and may be employed to manage certain forms of hemolytic anemia, particularly those induced by autoantibodies. The objective of this treatment is to diminish the concentration of detrimental antibodies that are attacking red blood cells.
These diverse treatment strategies ensure that care can be customized to meet the unique requirements of each patient, effectively addressing the specific type and underlying cause of their hemolytic anemia.
Frequently Asked Questions
Q: What should I expect if I have hemolytic anemia?
A: There are various ways that hemolytic anemia affects an individual. Hemolytic anemia can occasionally be a sign of a serious underlying medical problem that needs to be treated extensively. Hemolytic anemia can also occur as a side effect of some drugs and infections. In some situations, medical professionals treat the underlying infection or adjust the patient’s medicine to cure the illness.
Q: What steps can I take to lower my chance of hemolytic anemia?
A: Hemolytic anemia can arise from various sources, the majority of which are beyond your control. Hemolytic anemia, for instance, might occur from an injury or from inheriting specific diseases. However, by consulting your healthcare practitioner as soon as you notice any symptoms that might point to anemia, you can lower your chance of developing a serious condition.
Q: Which medication is the newest treatment for hemolytic anemia?
A: Pyrukynd (mitapivat) tablets have been approved by the FDA to treat individuals with pyruvate kinase (PK) deficiency for hemolytic anemia, a condition in which red blood cells are destroyed more quickly than they can be produced.
Q: Which are the two primary anemia treatments?
A: This type of anemia is typically treated with iron supplementation and dietary modifications. If blood loss is the root cause of iron deficiency, identifying and halting the bleeding is necessary. Surgery may be required for this.
A Note From BMTClinic
Hemolytic anemia happens when something is destroying your red blood cells. This condition may be a sign you have an inherited medical condition or a medical issue caused by infection. You may be reacting to specific medications. Regardless of the cause, your healthcare provider will focus on finding and treating the underlying cause.
Prompt treatment often makes the difference between getting well and getting worse. Hemolytic anemia symptoms may look and feel like less serious conditions. You know your body best, including how long it takes you to recover from everyday illnesses. Talk to your healthcare provider whenever you’re concerned about changes in your body that don’t go away.
