Hemolytic Anemia

Hemolytic anemia is a condition that destroys red blood cells before the normal lifespan has ended. These red blood cells are responsible for transporting oxygen from the lungs to the tissues and organs throughout the body. They are essential to maintaining life and preserving health.

Red blood cells are shaped a bit like doughnuts without the hole in the center. They are disk shaped and are also responsible for removing carbon dioxide from the body. They are made in the bone marrow which is a sponge like tissue inside the outer hard bone. The normal lifespan of a red blood cell is 120 days. At that point they die and are filtered out of the body through the spleen and eventually into the urine.

Hemolysis, the destruction of red blood cells, happens prematurely when the bone marrow cannot compensate for the loss. This destruction will change the clinical presentation depending upon whether it is gradual or abrupt and the severity of the destruction. In some patients the hemolysis may be mild and the patient can be asymptomatic, whereas in more serious cases, the anemia can be life-threatening.

The clinical presentation of hemolytic anemia will also reflect the underlying pathology, or cause, for the destruction of the red blood cells. For example, in individuals who suffer from sickle cell anemia the hemolysis is also associated with an occlusive crisis. This means that the red blood cells are destroyed in the smaller capillaries and produce a very painful crisis.

There are two types of hemolytic anemia, intrinsic and extrinsic. Individuals who suffer from in transit hemolytic anemia experience the distruction of red blood cells because of a defect within the cell it sells. These conditions produce red blood cells that do not live as long as normal red blood cells.

Individuals who suffer from extrinsic hemolytic anemia experience red blood cells which are healthy but later destroyed by becoming trapped in the spleen, destroyed by infection or from drugs. Extrinsic autoimmune hemolytic anemia can be caused by hepatitis, Epstein-Barr virus, Streptococcus, E. coli or medications such as penicillin, sulfa or acetaminophen. Leukemia or lymphoma as well as systemic lupus, rheumatoid arthritis or ulcerative colitis are also responsible for hemolytic anemia. Individuals who suffer from arsenic poisoning or use pyridium (a medication), certain chemotherapies or organic solvents are also at risk for developing hemolytic anemia.

An individual who is experiencing this type of anemia may present with symptoms that include abnormal paleness or lack of color in the skin, a yellowing of the skin or eyes, dark colored urine, fever, weakness, dizziness, confusion, enlargement of the spleen and liver, increased heart rate or a heart murmur.

All of these symptoms relate back to the responsibilities of the red blood cells for carrying oxygen throughout the body. The dark colored urine is a result of the extra amount of red blood cells being destroyed and excreted from the body. The diagnosis is usually made during a medical examination and through routine blood tests. Physicians will not only complete a medical history and physical exam, but also include additional tests and procedures to look for an enlarged spleen or liver.

Treatment for the condition will depend upon the type of hemolytic anemia the individual suffers from. Treating the symptom of the anemia will not help the condition if the underlying medical cause is not also addressed. Specific treatments will be based on your age and overall health, the extent of the underlying disease, your tolerance for specific procedures and therapies, the expectations for the course of the disease and your opinions or preference.

Treatments can include vitamin and mineral supplements to assist the body and producing healthy red blood cells, changing the diet, altering medications, treatment of the causative disease and in more severe cases, a splenectomy to remove the spleen. Medications such as corticosteroid, can be used to treat the anemia if it is not too severe.

Individuals who suffer from severe hemolytic anemia will need immediate hospitalization for a transfusion of washed, packed red blood cells. A severe anemia can aggravate any pre-existing heart or lung disease.

Treating this condition can be challenging and difficult depending upon the causative agent. However, with improvements in the medical field in the past decade recognition and treatment for this condition has improved, as has the lifespan of individuals suffer from it.

RESOURCES

PubMed Health: Hemolytic Anemia

National Heart Lung and Blood Insitute: Types of Hemolytic Anemia

University of Maryland Medical Center: Hemolytic Anemia

Johns Hopkins Medicine: Hemolytic Anemia