In hemolytic anemia, your body destroys red blood cells faster than your body can make new ones. When you have hemolytic anemia, your body does not receive enough oxygen, causing various problems. Red blood cells transport oxygen from your lungs to your organs and tissues.
The main types of hemolytic anemia are intrinsic and extrinsic. Intrinsic hemolytic anemia occurs when your red blood cells malfunction, which may be caused by inherited genetic disorders, such as sickle cell anemia, thalassemia, or G6PD deficiency. Red blood cells are more fragile and prone to breaking down when these disorders affect their shape, size, or function.
Extrinsic hemolytic anemia means that there is something outside of your red blood cells that causes them to be destroyed. This can be due to various factors, such as:
Infections, such as malaria, hepatitis, or Epstein-Barr virus
Autoimmune diseases, such as lupus or rheumatoid arthritis, where your immune system attacks your own red blood cells
Medications, such as antibiotics, painkillers, or antimalarials, that can trigger an allergic reaction or interfere with your red blood cell production
Mechanical damage, such as from artificial heart valves, blood clots, or severe burns, that can rupture your red blood cells
Blood transfusion, where you receive blood that is not compatible with your blood type, causing a severe immune reaction
The symptoms of hemolytic anemia depend on how fast and how severe your red blood cell destruction is. Some common symptoms include:
Fatigue, weakness, and dizziness
Pale or yellow skin and eyes (jaundice)
Dark or red urine
Shortness of breath and chest pain
Rapid or irregular heartbeat
Fever and chills
Enlarged spleen or liver
Some people may have mild or no symptoms, while others may have life-threatening complications, such as heart failure, kidney failure, or stroke.
To diagnose hemolytic anemia, your doctor will ask you about your medical history, symptoms, and family history. They will also perform a physical exam and order some blood tests, such as:
Complete blood count (CBC), which measures the number and size of your red blood cells, white blood cells, and platelets
Reticulocyte count, which measures the percentage of immature red blood cells in your blood
Bilirubin level, which measures the amount of a yellow pigment that is produced when red blood cells break down
Haptoglobin level, which measures the amount of a protein that binds to hemoglobin, the oxygen-carrying molecule in red blood cells
Lactate dehydrogenase (LDH) level, which measures the amount of an enzyme that is released when cells are damaged
Coombs test, which detects antibodies that may be attached to your red blood cells
Your doctor may also order other tests, such as urine tests, bone marrow biopsy, or genetic tests, to determine the specific cause of your hemolytic anemia.
The treatment of hemolytic anemia depends on the cause, severity, and symptoms of your condition. The main goals of treatment are to:
Stop or reduce the destruction of your red blood cells
Increase the production of your red blood cells
Replace the lost red blood cells
Manage the complications and symptoms of your condition
Some of the possible treatments include:
Medications, such as corticosteroids, immunosuppressants, or antibiotics, that can reduce inflammation, suppress your immune system, or treat infections
Blood transfusions, where you receive donated red blood cells to replenish your blood supply
Iron supplements, folic acid supplements, or erythropoietin injections, that can help your body make more red blood cells
Splenectomy, which is a surgery to remove your spleen, which is an organ that filters and destroys old or damaged red blood cells
Stem cell transplant, which is a procedure to replace your bone marrow, which is the source of your blood cells, with healthy stem cells from a donor
Some forms of hemolytic anemia, such as those caused by genetic disorders, cannot be prevented. However, you can take some steps to reduce your risk of developing or worsening hemolytic anemia, such as:
Avoiding or limiting exposure to substances that can trigger hemolytic anemia, such as certain medications, chemicals, or foods
Getting regular check-ups and blood tests to monitor your condition and detect any problems early
Following your doctor’s advice and taking your medications as prescribed
Eating a balanced diet that is rich in iron, folic acid, and vitamin B12, which are essential for red blood cell production
Drinking plenty of fluids to prevent dehydration and kidney damage
Avoiding strenuous activities or high altitudes that can reduce your oxygen levels
Seeking medical attention promptly if you have any signs or symptoms of hemolytic anemia or its complications
Your quality of life and health can be adversely affected by hemolytic anemia. However, with proper diagnosis, treatment, and care, you can manage your condition and live a fulfilling life. Talk to a hematologist, who is an expert in blood disorders, if you have any questions or concerns about hemolytic anemia.
