How to effectively manage hemolytic anemia?

Question

Hello doctor,

I am a 40-year-old female, 5'3" tall, and weigh 150 lbs. I have been getting blood work every six months for the past two years to monitor my reticulocyte count. My results show that my reticulocyte count is high at 140,668, my white blood cell count (WBC) is slightly low at 3.4, and my bilirubin sometimes goes high but stays at 0.2, which is the cutoff for high levels. My lethal dose one level is just above normal at 34, and my MCH (mean corpuscular hemoglobin) is slightly high at 33.2. I have been experiencing symptoms like palpitations, stomach pains, exhaustion, feeling cold all the time, and dizziness. Leukemia runs in my family, and I am also concerned about the possibility of hemolytic anemia.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

It seems like you might have hemolytic anemia, as your symptoms and signs are consistent with it. You should get a full evaluation to determine the cause, including a Coombs test (both direct and indirect antiglobulin tests). If someone in your family has the same issue, it could be hereditary hemolytic anemia. A peripheral blood film should be examined to check for spherocytes. Please send me the reports from the Coombs test and the peripheral blood film examination.

You should also start taking Folic acid tablets regularly, as you are anemic. It is good that you have not needed a blood transfusion, so there is no need to worry too much. Blood donation is not necessary at this time. It is important to look into conditions like hereditary spherocytosis, G6PD (glucose-6-phosphate dehydrogenase deficiency) deficiency, sickle cell anemia, and autoimmune hemolytic anemia, as all of these are possible in your case. A good hematologist can give you a diagnosis after reviewing your full history, examination, and lab results. They will also provide management advice.

You must manage any infections promptly with antibiotics, as infections can lead to hemolysis, anemia, and jaundice. Once you have the reports, send them to me, and I will guide you further.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.