- Hemolytic anemia can either be acquired or inherited. A genetic abnormality in the red blood cells is the underlying cause in the inherited cases. Anemia in the inherited cases occurs early in life. It includes thalassemia, sickle cell anemia, and spherocytosis (a condition in which the shape of the red blood cells is spherical instead of the normal doughnut-shape).
- People who have an inherited deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD), risk developing hemolytic anemia if the use certain medications like antimalarial drugs, antibiotics and methyldopa (used to treat hypertension).
- Infections such as hepatitis, cytomegalovirus, Epstein-Barr virus, typhoid fever, streptococcus, or Escherichia coli (E. coli).
- Hemolytic anemia due to another form of G6PD deficiency, which is common in the Greek isles, results from eating fava beans or inhaling its pollens.
- Some infectious diseases like malaria are known to destroy the red blood cells.
- Leukemia or lymphoma.
- TTP - Thrombotic thrombocytopenic purpura - Platelet aggregation on the microvascular endothelium.
- Family history of hemolytic anemia.
- Artificial heart valves, blood clots, or the abnormalities in the lining of the blood vessels can cause mechanical damage leading to the destruction of red blood cells.
- Fever and chills.
- Dark urine.
- Enlarged spleen.
- Pale skin color (pallor).
- Rapid heart rate (tachycardia).
- Shortness of breath (SOB).
- Yellow skin color (jaundice).
- Coombs test: The direct Coombs test is used clinically when immune-mediated hemolytic anemia (antibody-mediated destruction of RBCs) is suspected.
- Cold agglutinins: A high titre of anti-I antibody may be found in mycoplasma infections and a high titre of anti-I antibody may be found in hemolysis associated with infectious mononucleosis. An anti-P cold agglutinin may be seen in paroxysmal cold hemoglobinuria.
- Iron therapy: This is indicated for patients with severe intravascular hemolysis in which persistent hemoglobinuria has caused substantial iron loss. Iron stores increase in hemolysis and so iron administration is generally contraindicated in hemolytic disorders, particularly those that require chronic transfusion support.
- Immunosuppressant drugs may be given to treat hemolytic anemia if it is caused by an autoimmune disorder.
- Corticosteroid drugs, such as prednisone, may help prevent the destruction of red blood cells.
- Anemia caused by hereditary spherocytosis can be greatly improved if the patient gets his/her spleen removed because the spleen is the main site of the destruction of red blood cells.
- Administer folic acid because active hemolysis may cause folate deficiency. Discontinue medications that may have precipitated or aggravated hemolysis.
- Transfusion Therapy: Avoid transfusions unless absolutely necessary, but they may be essential. In autoimmune hemolytic anaemia, type matching and cross matching may be difficult. Use the least incompatible blood if transfusions are indicated. The risk of acute haemolysis of transfused blood is high, but the degree is dependent on the rate of infusion.
- Finally, bone marrow transplants are recommended in severe forms of acquired hemolytic anemia.
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