Anemia, Hemolytic

This is an uncommon anemia that develops when red blood cells are destroyed faster than bone marrow can replace them. The result is a shortage of red blood cells to transport oxygen. Early destruction can result from genetic defects or acquired defects.

Genetic defects in the red blood cells’ physical or chemical makeup can lead to a rigid or elongated shape. The deformity causes red blood cells to become trapped in the spleen, where most are destroyed before the end of their normal lifespan. More commonly, defective hemoglobin causes red blood cells to develop a crescent (sickle) shape. Sickle cells lodge in small arteries, causing acute pain and blood clots.

Acquired defects can occur when certain infections or the use of antibiotics or anti-inflammatory drugs break down red blood cells. Occasionally, one can acquire a mild form of anemia through an autoimmune process. Some artificial heart valves increase the risk of red blood cell destruction by directly injuring cells.

Sickle Cell Anemia

Sickle Cell anemia is a group of inherited red blood cell disorders. Normal red blood cells are round like doughnuts, and move through small blood tubes in the body to deliver oxygen. Sickle red blood cells become hard, sticky and crescent-shaped. When these cells go through the capillaries, they clog the flow and break apart. This can cause pain, damage, a low blood count or anemia.

There is a substance in the red cells called hemoglobin that carries oxygen. One little change in this substance causes the hemoglobin to form long rods in the red cell when it gives away oxygen. These rigid rods change the red cell into a sickle shape.

A person inherits the abnormal hemoglobin from both parents who may be carriers of the sickle cell trait or have sickle cell disease. In this case one is born with the sickle cell hemoglobin and it is present for life. Sickle cell occurs in many ethnic groups including African Americans, Arabs, Greeks, Italians, Latin Americans and Native Americans. All races should be screened for this hemoglobin at birth.

A simple blood test called the hemoglobin electrophoresis can be performed by a doctor or local sickle cell foundation. This test will determine whether a person is a carrier of the sickle cell trait or has the disease. Most states in the US now perform the sickle cell test when babies are born. Sickle cell trait does not adversely affect an individual’s life expectancy.

 


Signs, symptoms & indicators of Anemia, Hemolytic

Lab Values - Cells  

Macrocytic red cells



Lab Values - Common  

Rapid pulse rate



Symptoms - Cardiovascular  

(Possibly) enlarged spleen

Most of the hemolytic anemias can cause an enlarged spleen.



Symptoms - General  

Constant fatigue



Symptoms - Respiratory  

Easily being short of/always being short of breath



Symptoms - Skin - General  

Yellow-tinged skin



 

Lighter/paler skin color



Symptoms - Urinary  

Dark urine color




Conditions that suggest Anemia, Hemolytic

Circulation  

Pulmonary Embolism

Sickle cell disease increases the risk of pulmonary embolism.



Lab Values  


Symptoms - Cardiovascular  

(History of) hemolytic anemia



Counter Indicators
Symptoms - Cardiovascular  

Absence of hemolytic anemia




Risk factors for Anemia, Hemolytic

Autoimmune  

Lupus, SLE (Systemic Lupus Erythromatosis) / Risk

Anemia as a result of chronic inflammation is a characteristic but not especially common feature of active SLE.



Circulation  


Infections  


Lab Values - Chemistries  

High serum iron



Organ Health  



Anemia, Hemolytic suggests the following may be present

Autoimmune  

Lupus, SLE (Systemic Lupus Erythromatosis) / Risk

Anemia as a result of chronic inflammation is a characteristic but not especially common feature of active SLE.



Key

Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Very strongly or absolutely counter-indicative

Glossary

Anemia

A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.

Red Blood Cell

Any of the hemoglobin-containing cells that carry oxygen to the tissues and are responsible for the red color of blood.

Hemoglobin

The oxygen-carrying protein of the blood found in red blood cells.

Acute

An illness or symptom of sudden onset, which generally has a short duration.

Anti-inflammatory

Reducing inflammation by acting on body mechanisms, without directly acting on the cause of inflammation, e.g., glucocorticoids, aspirin.

Autoimmune Disease

One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.

Pulmonary

Pertaining to the lungs.

Embolism

Obstruction of a vessel by an abnormal body, usually a detached blood clot.

Chronic

Usually Chronic illness: Illness extending over a long period of time.

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