Hemolytic Anemia - Causes, Symptoms, Diagnosis, and Treatment

Creator: Dr. Megha Mohan Kumar
Published: 2022-08-02T17:15:47

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Hemolytic Anemia - Causes, Symptoms, Diagnosis, and Treatment

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Hemolytic anemia refers to an abnormal breakdown of red blood cells where they are destroyed faster than they can be replaced. Read the article to know more.

Written by

Dr. Megha Mohan Kumar

Medically reviewed by

Dr. Mohammad Rajja

August 2, 2022

August 11, 2023

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Contents

How Is Hemolytic Anemia Caused?
How Do Hemolytic Anemia Symptoms Manifest?
How Is Hemolytic Anemia Diagnosed?
What Are the Treatments for Hemolytic Anemia?

Introduction

Hemolytic anemia is a medical condition in which the life span of red blood cells is either reduced or prematurely destroyed.The condition of red blood cells being destroyed is called hemolysis. Red blood cells act as a transport medium to carry oxygen to all parts of the body. If there is a lower amount of red blood cells, then the individual is said to be anemic.

There are two possible sources of being exposed to hemolytic anemia. This medical condition can either be from an inherited source or an acquired source. The inherited source refers to that situation where this condition is passed on from one or more genes of a person who has already been suffering from hemolytic anemia. The acquired source is a self-developed condition via several sub-sources, which will be described in detail in the following article.

How Is Hemolytic Anemia Caused?

As mentioned, apart from hereditary source probabilities, there are several other possibilities for being exposed to self-developing situations as well. Few of them are –

Viral or bacterial infections.
Blood cancer.
Certain types of tumors.
Risk through blood transfusion.
Improper functioning of heart valves.
Drug-induced situations – In some instances, this disorder can be acquired due to the usage of some medications as well. A few of them are as follows:
- Acetaminophen.
- Penicillin.
- Chlorpromazine.
- Antimalarial medicines.
- Rifampin.
- Sulfa medicines.

How Do Hemolytic Anemia Symptoms Manifest?

There are various causes and sources of hemolytic anemia. We cannot specifically pinpoint one or two symptoms. A mix of one or two of these below-listed symptoms can be common for any sort of anemic disease. However, we can look into some shared symptoms we often catch up with -

Fatigue- This is a physically exhausting condition that impacts the energy levels from even doing the daily routines.
Shortness of Breath (Dyspnea)- Individuals might be feeling difficulty in breathing which may further lead to air hunger or suffocation. This is because red blood cells fail to carry oxygen to the body.
Increased Heart Rate (Tachycardia)- This is a condition where the heart will be beating faster than it is supposed to.
Jaundice- Jaundice could come with after-effects such as -
- Abnormal paleness.
- Yellowish skin and eyes.
- Increased levels of bilirubin.
Enlarged Spleen or Liver- Spleen and liver act as a filtering material for red blood cells while blood travels throughout the body. Damaged red blood cells will be instantly destroyed by the spleen and liver.

How Is Hemolytic Anemia Diagnosed?

Diagnosis of hemolytic anemia completely depends on symptoms, medical history of the patient, and pre-exposed medical conditions. In addition, there are few tests that could give the healthcare provider a fair idea. Usually, these tests are done in the same order as listed below.

Complete Blood Count (CBC)- This test measures each component of the blood specifically and lets patients know if they are anemic or not, along with several other outputs.
Other Blood Tests- If CBC results show anemia, a few other blood tests will be demanded, which include checking bilirubin, hemoglobin, liver function, and reticulocyte count.
Urine Test- Followed by other blood tests, patients might have to undergo a urine test to check the level of hemoglobin and iron, along with checking the possibility of dark urine.
Bone Marrow Biopsy and Aspiration- Bone Marrow Biopsy and aspiration test can provide information about how many red blood cells are being made, their size, and the maturity of cells.

What Are the Treatments for Hemolytic Anemia?

Hemolytic anemia does not come with a defined treatment protocol. The treatment completely depends on certain interpretations and findings that the healthcare provider has landed on considering the following factors –

Age.
Medical history.
How anemic they are.
Source of disease.
Probabilities of being responsive to certain medications.

Once the healthcare provider considers all these factors and reaches a conclusion on how this needs to be treated, one of the following choices of treatment will be preferred.

Red Blood Cells Transfusion- This is a treatment method preferred for early diagnosed patients where red blood cells will be added to increase the count or replace the destroyed red blood cells. This is applicable only when anemia is in a controlled situation.
Intravenous Immunoglobulin (IVIG)- IVIG is basically an immune booster that is given as an infusion through the veins. This treatment choice is mainly considered when the cause of hemolytic anemia is any sort of deficiency of immunity (immunodeficiency).
Splenectomy- Splenectomy refers to the surgery of the spleen being partially or fully removed. The spleen plays a crucial part in the body by filtering damaged cells which further helps prevent patients from being prone to infections. Splenectomy is often preferred as a treatment choice when the spleen is enlarged, damaged, or inefficient. Splenectomy is rarely chosen in situations when the immune system does not respond to steroids and immunosuppressant medications.
Plasmapheresis- Plasmapheresis is a method where the blood will be separated into comprising components using a machine. From separated components, plasma will be either replaced with donor plasma or will be discarded completely to replace with colloid fluid and injected back into the body. This will remove the antibodies which are causing harm to red blood cells.
Bone Marrow Transplant- Bone marrow transplant, also known as stem cell transplant, replaces the damaged bone marrow with healthy bone marrow. Before the replacement is done, the patient will be given high doses of chemotherapy or radiation therapy in order to make the body prepared for the process followed.

Conclusion

To sum up, hemolytic anemia has an unjudgeable nature which can develop quickly or slowly and can be mild or serious simultaneously. At the same time, this is a disorder anyone can live with as long as they are mild and given enough attention when required. Treatment for hemolytic anemia does not start with taking medication. Rather, seeking medical attention whenever the patients feel they are being followed by symptoms is the primary act of treatment. Severe versions of this disorder can even lead to serious heart problems. We cannot completely control the possibility of being affected by hemolytic anemia. However, the risk of being affected can be reduced by following a healthy diet that is rich in vitamin B9, B12 and C, along with following a regular exercise routine and maintaining a habit of being hydrated.

Frequently Asked Questions

1. What Is the Process That Occurs in Hemolytic Anemia?

Hemolytic anemia results from red blood cell destruction surpassing production, ultimately leading to insufficient hemoglobin levels and various effects like tiredness, yellowish skin tone, and exhaustion.

2. How Is Hemolytic Anemia Typically Treated?

Depending on its root cause, treatment entails interventions such as immunosuppressive medication administration or surgical removal of the spleen, which tends to be more affected compared to other organs.

3. Which Individuals Are Most Susceptible to Developing Hemolytic Anemia?

Individuals already diagnosed with genetic conditions resulting in hematological disorders (sickle cell anemia or thalassemia) have higher chances of experiencing this medical issue. At the same time, other risk factors could be traced back from medication usage or infections acquired.

4. Which Vitamin Deficiency Can Lead To Hemolytic Anemia?

A lack of vitamin B12 or folate (vitamin B9) can result in hemolytic anemia. Vitamin B12 and folate are essential for the synthesis of red blood cells. Inadequate quantities of these vitamins can affect red blood cell development and division, resulting in premature destruction and anemia. Inadequate dietary intake, malabsorption difficulties, certain medical conditions, or drugs that interfere with absorption can all cause vitamin deficiencies.

5. Which Medication Is Associated With Causing Hemolytic Anemia?

Certain medications have been associated with the onset of hemolytic anemia; these include drugs commonly utilized for malaria treatment and various forms of chemotherapy. Notably, allergies to penicillin have been linked with experiencing hemolytic anemia as a consequence of medication usage. Furthermore, Cyclophosphamide and Cisplatin, two commonly used chemotherapy drugs, may damage red blood cells and prompt the development of this condition accordingly.

6. Which Organ Is Primarily Affected by Hemolytic Anemia?

Hemolytic anemia does not exert a direct influence on organs. Nevertheless, due to this type of condition, bilirubin can accumulate within the body and get broken down by the liver; it's worth highlighting, though, that no harm directly relates to the health and functioning of this vital organ.

7. What Are Some Beneficial Vitamins for Managing Hemolytic Anemia?

When treating hemolytic anemia, some vitamins can help support the production of red blood cells and the body's health as a whole. Here are some important vitamins for dealing with severe anemia:
- Vitamin B12: This vitamin is important for making red blood cells that are healthy. It helps red blood cells grow and form, and you can get more of it through injections or oral pills.
- Folic acid (Vitamin B9): Folic acid is needed to make new cells, such as red blood cells. In cases of hemolytic anemia caused by a lack of folate, taking folic acid as a supplement can help.
- Vitamin C: Vitamin C helps the body absorb iron, which is important for making red blood cells that are healthy. It is also an antioxidant that keeps red blood cells from getting hurt.
- Vitamin E: The antioxidant qualities of vitamin E help protect red blood cells from damage caused by oxidative stress. In some cases of hemolytic anemia caused by oxidative causes, it may be helpful.
It is important to remember that the vitamins you need to take to treat hemolytic anemia can change based on what is causing it

8. What Diagnostic Tests Are Commonly Used to Identify Hemolytic Anemia?

Common diagnostic tests used to identify hemolytic anemia include:
- Complete Blood Count (CBC): Measures red blood cell count, hemoglobin levels, and hematocrit to assess anemia severity.
- Peripheral Blood Smear: Examines a blood sample under a microscope to check for abnormal red blood cell shapes or fragments.
- Reticulocyte Count: Determines the percentage of immature red blood cells, indicating bone marrow's response to red blood cell loss.
- Bilirubin Levels: Measures levels of bilirubin, a byproduct of red blood cell breakdown, which can be elevated in hemolysis.
- Coombs Test: Detects antibodies or complement proteins attached to red blood cells, helping diagnose immune-mediated hemolytic anemia.
These tests help healthcare professionals evaluate red blood cell parameters, detect abnormalities, and identify potential causes of hemolytic anemia

9. Are There Specific Foods That Can Help With Hemolytic Anemia?

While there are no specific foods that can directly treat hemolytic anemia, maintaining a balanced diet is important. Focus on consuming iron-rich foods like lean meats, seafood, beans, and leafy green vegetables to support red blood cell production. Include folate-rich foods such as dark leafy greens, asparagus, and citrus fruits to address folate deficiency-induced anemia. Additionally, incorporating vitamin C-rich foods like citrus fruits and bell peppers can enhance iron absorption.

10. Does a Particular Blood Type Have a Higher Risk of Hemolytic Anemia?

No, there is no one type of blood that is more likely to cause hemolytic anemia. Hemolytic anemia can happen to anyone, no matter what type of blood they have. Most of the time, things like autoimmune disorders, genetic conditions, infections, drug reactions, or certain diseases are to blame for the chance of hemolytic anemia. These things have nothing to do with a specific blood type, but rather with a person's health and situation.

11. What Is the Initial Treatment Option Recommended for Hemolytic Anemia?

Hemolytic anemia is best treated by identifying its cause. Immunosuppressive medicines can reduce it if autoimmune disorders cause the immune system to target healthy red blood cells. Vitamin and enzyme deficiencies require supplements. Transfusing healthy blood into a patient whose body can no longer handle low red blood cell levels is unusual yet extreme.

12. Is Low Hemoglobin a Characteristic of Hemolytic Anemia?

Hemolytic anemia typically results in reduced hemoglobin levels, destroying red blood cells. Hemoglobin, found in these cells, is crucial in binding oxygen for distribution throughout the body.

13. What Are the Typical Bilirubin Levels Seen in Hemolytic Anemia?

One indication of hemolytic anemia is increased bilirubin production due to the breakdown of red blood cells. Bilirubin appears as a bright yellow pigment, and excess amounts may lead to jaundice - where discoloration occurs in both skin and eye whites due to accumulation.

14. What Are Some Complications Associated With Hemolytic Anemia?

One affected by hemolytic anemia should expect several difficulties, such as weariness, respiratory issues, and bouts of vertigo, coupled with a higher chance of contracting infections. The outcomes might involve irreversible harm inflicted upon important bodily organs or mortal danger.

15. Is Hemolytic Anemia a Liver Disease?

Many people mistakenly think that hemolytic anemia is the same as liver disease, even though processing high amounts of bilirubin is just one of many things that can cause red blood cells to become unstable and cause the same symptoms. Even though red blood cell damage is the main cause of these effects, the things that put people at risk for this illness can be very different.

16. Which Bacteria is Responsible for Causing Hemolytic Anemia?

Evidence points to bacterial infections as a significant factor, especially those stemming from pathogens like streptococcus and staphylococcus inducing cascading immune responses leading to damaged RBCs. While it is true that jaundice may signal hemolytic anemia, it is not necessarily present in all cases. Bilirubin accumulation resulting from RBC breakdown could lead to yellowness in one's skin.

17. Does Hemolytic Anemia Cause Jaundice?

Someone suffering from hemolytic anemia by physical symptoms alone would be unwise as not all cases lead to jaundice. Additional indications of anemia comprise exhaustion, pallidness of the skin, a rapid heartbeat, and insufficient oxygen intake leading to shortness of breath.

Sources

Dr. Mohammad Rajja

General Practitioner

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