Hemolytic Anemia

What is hemolytic anemia?

Hemolytic anemia is a disorder in which red blood cells are destroyed faster than they can be made. The destruction of red blood cells is called hemolysis.

Red blood cells carry oxygen to all parts of your body. If you have a lower than normal amount of red blood cells, you have anemia. When you have anemia, your blood can’t bring enough oxygen to all your tissues and organs. Without enough oxygen, your body can’t work as well as it should.

Hemolytic anemia can be inherited or acquired:

• Inherited hemolytic anemia. This happens when parents pass the gene for the condition on to their children.

• Acquired hemolytic anemia. This is not something you are born with. You develop the condition later.

What causes hemolytic anemia?

Different diseases, conditions, or factors can cause each type.

Inherited

With the inherited type, parents pass the genes for the condition on to their children. Two common causes of this type of anemia are sickle cell anemia and thalassemia. These conditions create red blood cells that don’t live as long as normal red blood cells.

Acquired

With this type of anemia, you are not born with a certain condition. Your body makes normal red blood cells, but they are later destroyed. This may happen because of:

• Certain infections, which may be viral or bacterial

• Medicines, such as penicillin, antimalarial medicines, sulfa medicines, or acetaminophen

• Blood cancers

• Autoimmune disorders, such as lupus, rheumatoid arthritis, or ulcerative colitis

• Certain tumors

• An overactive spleen (hypersplenism)

• Mechanical heart valves that may damage red blood cells as they leave the heart

• A severe reaction to a blood transfusion

What are the symptoms of hemolytic anemia?

Each person’s symptoms may vary. Symptoms may include:

• Abnormal paleness or lack of color of the skin

• Yellowish skin, eyes, and mouth (jaundice)

• Dark-colored urine

• Fever

• Chills

• Weakness

• Dizziness

• Confusion

• Can’t handle physical activity

• Fatigue

• Shortness of breath

• Backache

• Enlarged spleen and liver

• Increased heart rate (tachycardia)

• Heart murmur

The symptoms of hemolytic anemia may look like other blood conditions or health problems. Always see your healthcare provider for a diagnosis.

How is hemolytic anemia diagnosed?

Your healthcare provider may think you have hemolytic anemia based on your symptoms, your health history, and a physical exam. Your provider may also order the following tests:

• Complete blood count (CBC). This test measures many different parts of your blood.

• Other blood tests. If the CBC test shows that you have anemia, you may have other blood tests. These can find out what type of anemia you have and how serious it is.

• Urine test. This can check for hemoglobin and iron. Hemoglobin is a protein in red blood cells.

• Bone marrow aspiration or biopsy. This involves taking a small sample of bone marrow fluid (aspiration) or solid bone marrow tissue (core biopsy). The sample is often taken from the hip bones. It is checked for the number, size, and maturity of blood cells or abnormal cells. A bone marrow test is often not needed to diagnose hemolytic anemia. But it may be used to assess other causes of anemia.

How is hemolytic anemia treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on the cause and how severe the condition is.

The treatment for hemolytic anemia will vary depending on the cause of the illness. Treatment may include:

• Blood transfusions

• Corticosteroid medicines

• Treatment to strengthen your immune system using intravenous immune globulin

• A medicine called rituximab

• Folic acid supplementation

In more severe cases, the following treatments may be needed:

• Surgery to remove the spleen

• Medicine to reduce the strength of your immune system (immunosuppressive therapy)

Living with hemolytic anemia

Work with your healthcare provider to reduce your risk of red blood cell breakdown and your risk for infections. For some people with hemolytic anemia, cold weather can often trigger the breakdown of red blood cells. To protect yourself, stay out of the cold, wear warm clothes, and keep your home warmer.

You can also reduce your risk for infections by:

• Staying away from people who are sick

• Staying away from large crowds

• Washing your hands often

• Not eating undercooked foods

• Brushing your teeth regularly

• Getting a flu shot each year

Key points about hemolytic anemia

• Hemolytic anemia is a disorder in which the red blood cells are destroyed faster than they are made.

• Inherited hemolytic anemia means that parents pass the gene for the condition on to their children.

• Acquired hemolytic anemia is not something you are born with. You develop the condition later.

• Symptoms include weakness, paleness, jaundice, dark-colored urine, fever, inability to do physical activity, and heart murmur.

• Treatment includes blood transfusions, corticosteroids, and other medicines.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are and when they should be reported.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions.