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Hemolytic anemia caused by chemicals and toxins

Anemia - hemolytic - caused by chemicals or toxins

Hemolytic anemia caused by chemicals and toxins is a lack of red blood cells that occurs when red blood cells are excessively damaged by certain chemicals or toxins.

Causes

Possible substances that can cause hemolytic anemia include:

  • Anti-malaria drugs (quinine compounds)
  • Arsenic
  • Dapsone
  • Intravenous water infusion (not half-normal saline or normal saline)
  • Metals (chromium/chromates, platinum salts, nickel compounds, copper, lead, cis-platinum)
  • Nitrites
  • Nitrofurantoin
  • Penicillin
  • Phenazopyridine (Pyridium)
  • Rho immune globulin (WinRho)
  • Ribavirin
  • Snake bites (some snake venom contains hemolytic toxins)
  • Sulfonamides
  • Sulfones

This list is not all-inclusive.

References

Little M. Anaemia. In: Cameron P, Little M, Mitra B, Deasy C, eds. Textbook of Adult Emergency Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 13.1.

Mentzer WC, Schrier SL. Extrinsic nonimmune hemolytic anemias. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 47.

Michel M. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 151.

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Review Date: 1/25/2022

Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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