Hemolytic anemia
Anemia - hemolyticAnemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues.
Anemia
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...
Read Article Now Book Mark ArticleNormally, red blood cells last for about 120 days in the body. In people with hemolytic anemia, red blood cells in the blood are destroyed earlier than normal.
Causes
The bone marrow is mostly responsible for making new red cells. Bone marrow is the soft tissue in the center of bones that helps form all blood cells.
Hemolytic anemia occurs when the bone marrow isn't making enough red cells to replace the ones that are being destroyed.
There are several possible causes of hemolytic anemia. Red blood cells may be destroyed due to:
- An autoimmune problem in which the immune system mistakenly sees your own red blood cells as foreign substances and destroys them
Autoimmune problem
An autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...
Read Article Now Book Mark Article - Genetic variations within the red cells (such as sickle cell anemia, thalassemia, and G6PD deficiency)
Sickle cell anemia
Sickle cell disease is a disorder passed down through families. The red blood cells that are normally shaped like a disk take on a sickle or crescen...
Read Article Now Book Mark ArticleThalassemia
Thalassemia is a blood disorder passed down through families (inherited) in which the body makes an abnormal form or inadequate amount of hemoglobin....
Read Article Now Book Mark ArticleG6PD deficiency
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a condition in which red blood cells break down when the body is exposed to certain medicines ...
Read Article Now Book Mark Article - Exposure to certain chemicals, medicines, and toxins
- Infections
- Blood clots in small blood vessels
- Transfusion of blood from a donor with a blood type that does not match yours
- Faulty, damaged, or artificial heart valves
Symptoms
You may not have symptoms if the anemia is mild. If the problem develops slowly, the first symptoms may be:
- Feeling weak or tired more often than usual, or with exercise
- Feelings that your heart is pounding or racing
- Headaches
Headaches
A headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...
Read Article Now Book Mark Article - Problems concentrating or thinking
If the anemia gets worse, symptoms may include:
- Lightheadedness when you stand up
- Pale skin
- Shortness of breath
Shortness of breath
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
Read Article Now Book Mark Article - Sore tongue
- Left upper abdominal pain due to an enlarged spleen
Enlarged spleen
Splenomegaly is a larger-than-normal spleen. The spleen is an organ in the upper left part of the belly.
Read Article Now Book Mark Article
Exams and Tests
A test called a complete blood count (CBC) can help diagnose anemia and offer some hints to the type and cause of the problem. Important parts of the CBC include red blood cell count (RBC), hemoglobin, and hematocrit (HCT).
Complete blood count
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
Read Article Now Book Mark ArticleRed blood cell count
An RBC count is a blood test that measures how many red blood cells (RBCs) you have. RBCs contain hemoglobin, a protein which carries oxygen. How mu...
Read Article Now Book Mark ArticleHematocrit
Hematocrit is a blood test that measures how much of a person's blood is made up of red blood cells as opposed to plasma. This measurement depends o...
Read Article Now Book Mark ArticleThese tests can identify the type of hemolytic anemia:
- Absolute reticulocyte count
Reticulocyte count
Reticulocytes are slightly immature red blood cells. A reticulocyte count is a blood test that measures the amount of these cells in the blood....
Read Article Now Book Mark Article - Coombs test, direct and indirect
Coombs test, direct
The Coombs test looks for antibodies that may stick to your red blood cells and cause red blood cells to die too early.
Read Article Now Book Mark Article - Donath-Landsteiner test
Donath-Landsteiner test
The Donath-Landsteiner test is a blood test to detect harmful antibodies related to a rare disorder called paroxysmal cold hemoglobinuria. These ant...
Read Article Now Book Mark Article - Cold agglutinins
Cold agglutinins
Agglutinins are antibodies that cause the red blood cells to clump together. Cold agglutinins are active at cold temperatures. Febrile (warm) aggluti...
Read Article Now Book Mark Article - Free hemoglobin in the serum or urine
Hemoglobin
Hemoglobin is a protein in red blood cells that carries oxygen. The hemoglobin test measures how much hemoglobin is in your blood.
Read Article Now Book Mark Article - Platelet count
Platelet count
A platelet count is a lab test to measure how many platelets you have in your blood. Platelets are particles in the blood that help the blood clot. ...
Read Article Now Book Mark Article - Protein electrophoresis - serum
Protein electrophoresis - serum
This lab test measures the types of protein in the fluid (serum) part of a blood sample. This fluid is called serum.
Read Article Now Book Mark Article - Serum immunofixation
- Pyruvate kinase
Pyruvate kinase
The pyruvate kinase test measures the level of pyruvate kinase enzyme in the blood. Pyruvate kinase is an enzyme found in red blood cells. It helps ...
Read Article Now Book Mark Article - Serum haptoglobin levels
Serum haptoglobin
The haptoglobin blood test measures the level of haptoglobin in your blood. Haptoglobin is a protein produced by the liver. It attaches to hemoglobi...
Read Article Now Book Mark Article - Serum LDH
Serum LDH
Lactate dehydrogenase (LDH) is a protein that helps produce energy in the body. An LDH test measures the amount of LDH in the blood.
Read Article Now Book Mark Article - Carboxyhemoglobin level
Carboxyhemoglobin level
Hemoglobin is a protein in red blood cells that moves oxygen and carbon dioxide between the lungs and body tissues. Hemoglobin derivatives are forms ...
Read Article Now Book Mark Article
Treatment
Treatment depends on the type and cause of the hemolytic anemia:
- In emergencies, a blood transfusion may be needed.
- For immune causes, medicines that suppress the immune system may be used.
- When blood cells are being destroyed at a fast pace, the body may need extra folic acid and iron supplements to replace what is being lost.
In rare cases, surgery is needed to take out the spleen. This is because the spleen acts as a filter that removes abnormal cells from the blood.
Outlook (Prognosis)
The outcome depends on the type and cause of hemolytic anemia. Severe anemia can make heart disease, lung disease, or cerebrovascular disease worse.
Cerebrovascular disease
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
Read Article Now Book Mark ArticleWhen to Contact a Medical Professional
Contact your health care provider if you develop symptoms of hemolytic anemia.
References
Araten DJ, Brodsky RA. Paroxysmal nocturnal hemoglobinuria. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 32.
Gallagher PG. Hemolytic anemias: red blood cell membrane and metabolic defects. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 147.
Kumar V, Abbas AK, Aster JC, Deyrup AT, Das A. Hematopoietic and lymphoid systems. In: Kumar V, Abbas AK, Aster JC, Deyrup AT, Das A, eds. Robbins and Kumar Basic Pathology. 11th ed. Philadelphia, PA: Elsevier; 2023:chap 10.
Mentzer WC, Schrier SL. Extrinsic nonimmune hemolytic anemia. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 48.
Michel M, Jäger U. Autoimmune hemolytic anemia. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 47.
Anemia
Animation
Red blood cells, sickle cell - illustration
Sickle cell anemia is an inherited blood disease in which the red blood cells produce abnormal pigment (hemoglobin). The abnormal hemoglobin causes deformity of the red blood cells into crescent or sickle-shapes, as seen in this photomicrograph.
Red blood cells, sickle cell
illustration
Red blood cells - multiple sickle cells - illustration
Sickle cell anemia is an inherited disorder in which abnormal hemoglobin (the red pigment inside red blood cells) is produced. The abnormal hemoglobin causes red blood cells to assume a sickle shape, like the ones seen in this photomicrograph.
Red blood cells - multiple sickle cells
illustration
Red blood cells - sickle cells - illustration
These crescent or sickle-shaped red blood cells (RBCs) are present with Sickle cell anemia, and stand out clearly against the normal round RBCs. These abnormally shaped cells may become entangled and block blood flow in the small blood vessels (capillaries).
Red blood cells - sickle cells
illustration
Red blood cells - sickle and Pappenheimer - illustration
This photomicrograph of red blood cells (RBCs) shows both sickle-shaped and Pappenheimer bodies.
Red blood cells - sickle and Pappenheimer
illustration
Blood cells - illustration
Blood is comprised of red blood cells, platelets, and various white blood cells.
Blood cells
illustration
Red blood cells, sickle cell - illustration
Sickle cell anemia is an inherited blood disease in which the red blood cells produce abnormal pigment (hemoglobin). The abnormal hemoglobin causes deformity of the red blood cells into crescent or sickle-shapes, as seen in this photomicrograph.
Red blood cells, sickle cell
illustration
Red blood cells - multiple sickle cells - illustration
Sickle cell anemia is an inherited disorder in which abnormal hemoglobin (the red pigment inside red blood cells) is produced. The abnormal hemoglobin causes red blood cells to assume a sickle shape, like the ones seen in this photomicrograph.
Red blood cells - multiple sickle cells
illustration
Red blood cells - sickle cells - illustration
These crescent or sickle-shaped red blood cells (RBCs) are present with Sickle cell anemia, and stand out clearly against the normal round RBCs. These abnormally shaped cells may become entangled and block blood flow in the small blood vessels (capillaries).
Red blood cells - sickle cells
illustration
Red blood cells - sickle and Pappenheimer - illustration
This photomicrograph of red blood cells (RBCs) shows both sickle-shaped and Pappenheimer bodies.
Red blood cells - sickle and Pappenheimer
illustration
Blood cells - illustration
Blood is comprised of red blood cells, platelets, and various white blood cells.
Blood cells
illustration
Review Date: 3/31/2024
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.