Hemolytic Anemia

Hemolytic anemia is a rare blood disorder in which red blood cells are rapidly destroyed.

The severity of this type of anemia is determined by how long the red blood cells live before being destroyed by the spleen and by how quickly the bone marrow can replace the red blood cells.

Intrinsic

Intrinsic hemolytic anemias are often inherited, such as thalassemia and sickle cell anemia. The bone marrow produces red blood cells which are defective so their lifespan is shorter than normal red blood cells.

Extrinsic

Extrinsic hemolytic anemia may also be referred to as autoimmune hemolytic anemia. The bone marrow produces red blood cells which are initially healthy. Some types of extrinsic hemolytic anemia are temporary and never return after treatment. Other types are chronic, which may have times of remission and then relapse. The red blood cells are subsequently destroyed by one of the following:

  • The red blood cells get trapped in the spleen
  • Infection
  • Taking medications that affect red blood cells
  • Various tumors
  • Autoimmune disorders
  • Leukemia or lymphoma
  • Abnormalities of the blood vessel

Sometimes an underlying disorder that causes anemia may also produce signs and symptoms similar to hemolytic anemia. Therefore, it is important to consult a doctor for a proper diagnosis.

The most common symptoms include:

  • Fatigue
  • Light headedness or dizzy feeling
  • Breathing problems when exercising
  • Irregular heartbeat

Other signs and symptoms may include:

  • Unusual paleness in the skin
  • Yellowing of the skin and eyes
  • Fever
  • Confusion
  • Dark color to urine
  • Enlargement of the spleen / liver
  • Kidney failure
  • Heart murmur

Hemolytic anemia can be diagnosed using the following tests:

The treatment plan for an individual with hemolytic anemia depends on the cause of the disorder. Treatment can also depend on the person's age, medical history and the severity of the anemia.

Treatment options may include:

  • Blood transfusions: Blood transfusions help to increase the number of available red blood cells used to carry oxygen to the body tissues.
  • Corticosteroids: Corticosteroids such as Prednisone can suppress an overactive immune system thereby limiting the destruction of the red blood cells. Common side effects may include weight gain, high blood pressure, acne, upset stomach and irritability.
  • Immune globulin (IVIG): IVIG decreases the destruction of red blood cells and is commonly used to treat autoimmune hemolytic anemia. Common side effects may include fever, chills, headache, light-headedness, flushing, itching and a change in blood pressure.

In more severe cases, the individual may have to be hospitalized and receive the following treatments:

  • Exchange transfusion: An exchange transfusion is similar to a blood transfusion. The difference is that unhealthy blood is actually removed while being replaced with an equal amount of healthy blood.
  • Splenectomy: The location of red blood cell destruction may be in the spleen. As a result, the spleen may need to be removed. This treatment option is typically reserved for people who do not respond to other therapies.
  • Immunosuppressive therapy: Immunosuppressive therapy is a treatment used to suppress the immune system. This type of treatment may help when the red blood cells are being destroyed by the patients own immune system (autoimmune hemolytic anemia).
  • Confusion
  • Increased problems with pain
  • Extreme fatigue
  • Increased shortness of breath

Last Updated 12/2013