Hemolytic anemia

Email this page to a friendShare on facebook Share on twitter Bookmark & Share Printer-
friendly version

Hemolytic anemia is a condition in which there are not enough red blood cells in the blood,
due to the premature destruction of red blood cells. There are a number of specific types of
hemolytic anemia, which are described individually.

Causes
Hemolytic anemia occurs when the bone marrow is unable to increase production to make up
for the premature destruction of red blood cells. If the bone marrow is able to keep up with
the early destruction, anemia does not occur (this is sometimes called compensated
hemolysis).

There are many types of hemolytic anemia, which are classified by the reason for the
premature destruction of red blood cells. The defect may be in the red blood cell itself
(intrinsic factors), or outside the red blood cell (extrinsic factors).

Intrinsic factors are often present at birth (hereditary). They include:

Abnormalities in the proteins that build normal red blood cells

Differences in the protein inside a red blood cell that carries oxygen (hemoglobin)

Extrinsic factors include:

Abnormal immune system responses

Blood clots in small blood vessels
Certain infections
Side effects from medications

Types of hemolytic anemia include:

Hemoglobin SC disease (similar in symptoms to sickle-cell anemia)

Hemolytic anemia due to G6PD deficiency
Hereditary elliptocytosis
Hereditary ovalocytosis
Hereditary spherocytosis
Idiopathic autoimmune hemolytic anemia
Malaria
Microangiopathic hemolytic anemia (MAHA)
Non-immune hemolytic anemia caused by chemicals or toxins
Paroxysmal nocturnal hemoglobinuria (PNH)
Secondary immune hemolytic anemia
Sickle-cell anemia
Thalassemia
Transfusion of blood from a donor with a different blood type
Symptoms
Chills
Dark urine
Enlarged spleen
Fatigue
Fever
Pale skin color (pallor)
Rapid heart rate
Shortness of breath
Yellow skin color (jaundice)

Exams and Tests

These are tests for red blood cell destruction (hemolysis). Specific tests can identify the types
of hemolytic anemia. They are usually performed when hemolysis is suspected or has been
determined.

Absolute reticulocyte count

Free hemoglobin in the serum or urine
Hemosiderin in the urine
Red blood cell count (RBC), hemoglobin, and hematocrit (HCT)
Serum haptoglobin levels
Serum indirect bilirubin levels
Serum LDH
Urine and fecal urobilinogen

Directly measuring the red cell life span with radioactive tagging techniques shows a
shortened life span.

This disease may also affect the following test results, depending on the specific cause:

AST
Coombs' test, direct
Coombs' test, indirect
Donath-Landsteiner test
Febrile or cold agglutinins
Leukocyte alkaline phosphatase
Peripheral blood smear
Platelet count
Protein electrophoresis - serum
RBC indices
Serum creatinine
Serum ferritin
Serum iron
Serum potassium level
Serum uric acid
TIBC
White blood count differential
Treatment
Treatment depends on the type and cause of the hemolytic anemia. Folic acid, iron
replacement, and corticosteroids may be used. In emergencies, a blood transfusion or removal
of the spleen (splenectomy) may be necessary.

Outlook (Prognosis)
The outcome depends on the type and cause of hemolytic anemia.

Possible Complications
The complications depend on the specific type of hemolytic anemia. Severe anemia can cause
cardiovascular collapse (failure of the heart and blood pressure, leading to death). Severe
anemias can worsen heart disease, lung disease, or cerebrovascular disease.

Stroke
Email this page to a friendShare on facebook Share on twitter Bookmark & Share Printer-
friendly version

A stroke happens when blood flow to a part of the brain stops. A stroke is sometimes called a
"brain attack."

Causes
If blood flow is stopped for longer than a few seconds, the brain cannot get blood and
oxygen. Brain cells can die, causing permanent damage.

There are two major types of stroke: ischemic stroke and hemorrhagic stroke.

Ischemic stroke occurs when a blood vessel that supplies blood to the brain is blocked by a
blood clot. This may happen in two ways:

A clot may form in an artery that is already very narrow. This is called a thrombotic
stroke.
A clot may break off from another place in the blood vessels of the brain, or from
some other part of the body, and travel up to the brain. This is called cerebral
embolism, or an embolic stroke.

Ischemic strokes may be caused by clogged arteries. Fat, cholesterol, and other substances
collect on the artery walls, forming a sticky substance called plaque
When to Contact a Medical Professional
Call for an appointment with your health care provider if you develop symptoms of hemolytic
anemia.

Prevention
There is no known prevention for hemolytic anemia.

Alternative Names
Anemia - hemolytic

References
Schwartz RS. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Ausiello D,
eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 164.

Powers A, Silberstein LE. Autoimmune hemolytic anemia. In: Hoffman R, Benz EJ, Shattil
SS, et al, eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier
Churchill Livingstone;2008:chap 47.

Schrier SL, Price EA. Extrinsic nonimmune hemolytic anemias. In: Hoffman R, Benz EJ,
Shattil SS, et al, eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa:
Elsevier Churchill Livingstone;2008:chap 48.

Nlm.com
Hemolytic Anemia Complications
Complications of hemolytic anemia include:

Congestive heart failure

Heart attack
Angina

Seseorang dengan angina memiliki nyeri dada atau ketidaknyamanan dada, yang disebabkan
oleh pengiriman oksigen rendah ke otot jantung. Dalam kebanyakan kasus, hal ini
disebabkan oleh penyakit arteri koroner, penyempitan pembuluh darah yang memasok
darah beroksigen ke jantung. Gejala-gejala angina terjadi ketika pasokan oksigen tidak dapat
memenuhi permintaan. Angina tidak stabil menggambarkan gejala angina yang baru,
memburuk, atau terjadi lebih sering.

Kidney failure
Nutritional deficiencies
Stroke

Freemd.com

Complications
Anaemia may lead to high-output cardiac failure.
Jaundice creates problems associated with increased unconjugated bilirubin.
In patients with intravascular haemolysis, iron deficiency due to chronic
haemoglobinuria can exacerbate anaemia and weakness.

Anemia dapat menyebabkan high-output gagal jantung.

Penyakit kuning menciptakan masalah yang terkait dengan bilirubin tak
terkonjugasi meningkat.
Pada pasien dengan hemolisis intravaskular, kekurangan zat besi karena
haemoglobinuria kronis dapat memperburuk anemia dan kelemahan.

Patient.co.uk

1. Clinical complications due to severe hemolytic anaemia - slowed growth and development in
children - bilirubins stones - aplastic crisis - congestive heart failure from chronic anemias
and cardiac overload compensation 2. Consequences of vaso-occlusion of the
microcirculations (tissue ischemia and infarction) - infarction of spleen, brain, marrow,
kidney, lung, aseptic necrosis, central nervous system and ophtalmic vascular lesions
1. Komplikasi klinis akibat anemia hemolitik berat - memperlambat pertumbuhan dan
perkembangan pada anak - bilirubins batu - krisis aplastik - gagal jantung kongestif dari
anemia kronis dan kompensasi kelebihan beban jantung 2. Konsekuensi vaso-oklusi dari
microcirculations (jaringan iskemia dan infark) - infark limpa, pembuluh darah lesi otak,
sumsum, ginjal, paru-paru, nekrosis aseptik, sistem saraf pusat dan ophtalmic