What is Hemolytic Anemia?
Hemolytic anemia is a process by which red blood cells are destroyed. There are many causes of hemolytic anemia. The type of hemolytic anemia depends on the way the red blood cells are destroyed. There are different treatments for each type of hemolytic anemia. When your body destroys red blood cells, your bone marrow must make new red blood cells faster than normal. Some hemolytic anemias are rapid and life threatening, while others are slower and have more chronic problems. How severe the hemolytic anemia is depends on how quickly cells are being broken down and on how quickly the bone marrow can replace the red blood cells.
Types of Hemolytic Anemia
Intrinsic
Intrinsic hemolytic anemias are genetic conditions that you are born with. These are called congenital hemolytic anemias. There are many types of congenital hemolytic anemias. This includes sickle cell anemia, hereditary spherocytosis, pyruvate kinase deficiency, and G6PD deficiency.
Extrinsic
Extrinsic hemolytic anemias occur after you are born. They are caused by immune problems, medicines and other factors. The most common extrinsic form is autoimmune hemolytic anemia. This is when your body’s immune system becomes confused and makes antibodies that attack your own blood cells. When your body attacks its own cells, it is called “autoimmune.” In autoimmune hemolytic anemia, your body’s immune system thinks that your own blood cells are “foreign” to your body. Your system targets these blood cells to be destroyed and removed by the spleen. The exact cause is not always known, but it can be triggered by a viral illness or by vaccinations. This process can be very quick. It can lead to low blood counts and the need for a hospital stay. A blood transfusion may be needed. Autoimmune hemolytic anemia is treated with medicines such as steroids. Steroids decrease the intensity of the immune system. Treatment must often continue for a long time until the immune system stops destroying blood cells.
Signs and Symptoms of Hemolytic Anemia
There are two main causes of symptoms with hemolytic anemia. One set of symptoms is due to the anemia (low blood counts). The other symptoms are the results of the red blood cells breaking down in your blood stream and body. These symptoms are not specific to hemolytic anemia. It is important to know that there can be other causes for these symptoms. It is vital to always consult a doctor for a proper diagnosis.
The most common symptoms include:
- Fatigue (very tired feeling)
- Light-headedness or dizzy feeling
- Breathing problems when exercising
- Irregular heartbeat
- Yellowing of the skin, eyes
- Dark-colored urine
Other signs and symptoms may include:
- Paleness in the skin that is not normal
- Fever
- Confusion
- Spleen / liver has gotten larger
- Kidney failure
- Heart murmur
Diagnosis of Hemolytic Anemia
These tests are used for diagnosis:
- Physical exam
- Blood tests
- Urine tests
- Bone marrow biopsy and aspiration
Treatment for Hemolytic Anemia
The treatment plan for a person with hemolytic anemia depends on the cause of the disorder. Treatment can also depend on the person's age, medical history and how severe the anemia is. Someone diagnosed with hemolytic anemia will have their labs monitored frequently for a period of time, sometimes weekly or monthly depending on their treatment and severity of symptoms.
Treatment options may include:
- Blood transfusions: To help to increase the number of available red blood cells to carry oxygen to the body tissues.
- Corticosteroids: Steroids, such as Prednisone, can suppress an overactive immune system. This limits 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): An intravenous infusion that decreases the destruction of red blood cells. It is often 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 person may have to stay in the hospital. They may receive these treatments:
- Exchange transfusion: This is like a blood transfusion. The difference is that unhealthy blood cells are actually removed while being replaced with the same 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 most often used in people who do not respond to other therapies.
- Immunosuppressive therapy: This therapy is used to suppress the immune system. This may help when the red blood cells are being destroyed by the patient’s own immune system (autoimmune hemolytic anemia). These treatments are most often used in patients who do not respond well to other common treatments.
Call Your Child's Doctor if Your Child Has:
- Confusion
- Increased problems with pain
- Extreme fatigue (feeling very tired or weak)
- Increased shortness of breath (hard to breath)
