What Is Hemolysis?

Introduction

Hemolysis is an act of red blood cells being broken down or destroyed. This can be accounted as a basic human body function as well as a medical condition. Acting as body function, red blood cells are supposed to be broken down when it reaches their mature age or gets faulty or inefficient. On the other end, hemolysis exposes a medical condition of red blood cells being destroyed before they can be replaced.

Even though there are several causes for hemolysis, it can be collectively called an after-effect of hemolytic anemia. Normally red blood cells have a lifespan of 120 days. Once red blood cells reach this period, the spleen (an internal organ located near ribs to filter damaged red blood cells) will remove these red blood cells from the body. When someone is diagnosed with hemolytic anemia, the lifespan of red blood cells will be shortened. Still, the spleen will function like always and filter those red blood cells.

Here, the functioning of the spleen will become critical since they have to work more often than usual, which will eventually lead to life-threatening situations unless given proper attention and medication. Hemolysis can also occur due to certain medications.

What Does Hemolysis Mean?

Hemolysis is the rupture of erythrocyte membranes (known as the membrane of RBC), ultimately resulting in hemoglobin release. Hemolysis, often referred to as erythrocyte necrosis (a condition that has been linked to red blood cell damage), takes place at the termination of each erythrocyte's life.

What Are the Causes of Hemolysis?

The red blood cells usually die off when they become old and get replaced. Therefore hemolysis occurs in the body normally. Hemolytic anemia arises when the hemolysis causes a decrease in the number of red blood cells. Numerous factors, such as the following, could induce hemolysis to occur too quickly or too frequently:

• Autoimmune diseases.

• Failure of the bone marrow.

• Blood transfusion complications.

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• Several infections.

• Blood disorders inherited from parents, such as sickle cell disease or thalassemia.

• Some medications can also trigger hemolysis.

What Are the Different Types of Hemolysis?

Hemolysis has been classified into three divisions based on grades of bacterial involvement and the destruction or breakdown of red blood cells. Before getting into the three types of hemolysis, we should get to know how the classifications are derived. As we stated above, bacterial involvement is a crucial part of the classification of hemolysis. The red blood cells which are affected by bacteria, release toxins that will be transferred to other cells. This bacterial involvement is differentiated using the blood agar test. Blood agar is a rich and complex solid medium used for the enormous growth of bacteria. As a result, blood agar helps in obtaining a diverse range of bacteria from limited samples. Blood agar is an artificially made medium with several chemical ingredients and rabbit or sheep blood, depending on the target bacterium.

• Alpha Hemolysis -

Alpha hemolysis has a greenish nature while looking upon blood agar. So, if the blood agar results look greenish or brownish, it is said to be affected by alpha hemolysis. This greenish coloration is because the red blood cell hemoglobin will be converted to methemoglobin. Alpha hemolysis refers to whether someone is affected with partial hemolysis or incomplete hemolysis.

• Beta Hemolysis -

Beta hemolysis has a clear and evident bacterial infection when looked upon on the blood agar plate. Thus, beta hemolysis refers to a completely affected hemolysis scenario. Here, the release of toxins from bacteria will be on the higher side.

• Gamma Hemolysis -

Gamma hemolysis refers to a non-hemolytic condition. There will not be any influential bacterial involvement for the first 24 hours when looked upon on the blood agar plate. Later after 24 hours, there is a slight chance for the presence of weak alpha hemolysis.

When Do the Symptoms of Hemolysis Appear?

The role of a doctor comes into the picture when someone feels the below-listed symptoms constantly. The symptoms of hemolysis are similar to hemolytic anemia. Here are a few symptoms commonly observed:

• Fatigue – Fatigue is a physical or mental state of extreme tiredness which impacts the energy levels from even doing any daily routines.

• Dizziness – This is a sensation of feeling physically unstable due to a spinning head or light-headedness or loss of balance.

• Jaundice – Jaundice could come with after-effects such as:

o Abnormal paleness.

o Yellowish skin and eyes.

o Increased levels of bilirubin.

• Enlarged Spleen or Liver– Spleen and liver work as an internal filtering device that prevents the damaged and matured red blood cells from circulating throughout the body. Damaged, inefficient, or aged red blood cells will be destroyed by the spleen.

• Heart Palpitations – This is not a medical condition but an occurrence where the heart will pound irregularly. This can be in terms of too slow, too fast, or too hard.

How Is Hemolysis Treated?

Hemolysis does not have a recorded treatment protocol. The treatment completely depends on factors like:

• Patient’s age.

• Patient’s health and medical history.

• Patient’s probability of responding to medications.

• The intensity of the condition.

After considering the above factors, one or more of the below treatment courses will be chosen by the healthcare provider.

• Blood Transfusion: Blood transfusion refers to the process of red blood cells being added or replaced to stabilize the condition. Patients who have been diagnosed with hemolysis at early stages are prone to have these transfused red blood cells last longer.

• Intravenous Immunoglobulin (IVIg): Intravenous immunoglobulin acts as a booster and a form of resistance in patients suffering from hemolytic anemia. This medication is administered by injection into the veins.

• Folate Supplements: Folate or folic acid is basically vitamin B (vitamin B9 or B12). Taking vitamin B supplements will aid the body in the production of new red blood cells as well as in the function and growth of existing red blood cells.

• Splenectomy: Splenectomy is the process of removing the spleen partly or completely. Splenectomy is chosen only when the spleen is the most affected part where the spleen could be inefficient, or enlarged or damaged.

• Bone Marrow Transplant: A bone marrow transplant replaces the inefficient bone marrow with healthy bone marrow. As a result, the body will produce sufficient healthy red blood cells.

Conclusion

Hemolysis is not a severe medical condition. It is a basic human body function, but it could get converted into a medical condition if not identified and given proper medical attention at the right time.

However, several medical conditions, medications, and substances might cause RBCs to degenerate early. When this happens, patients may develop anemia symptoms such as tiredness, dizziness, and headaches. In certain circumstances, the symptoms are more severe.

A severe version of hemolysis could bring down the life expectancy level. People cannot avoid being affected by this phenomenon; however, it can reduce the probability of being adversely affected by taking folic acid supplements, doing regular exercises, and doing routine health check-ups. A person who exhibits early signs of anemia should see a doctor for a prompt diagnosis and treatment.