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What is Hemolytic Anemia?

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  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 25 August 2016
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Hemolytic anemia refers to an abnormally fast breakdown of red blood cells. While most red blood cells live for three to four months, hemolytic anemia can translate to much quicker breakdown, resulting in fewer than normal blood cells, excess bleeding, low iron counts, and jaundice. The condition can be a temporary one, and has numerous causes, either classed as genetic or acquired.

Genetic causes of hemolytic anemia include conditions like sickle cell anemia. Other conditions that can create hemolytic anemia are often rare disorders like spherocytosis, a disorder of the spleen, or elliptocytosis, where the blood cells themselves have an elliptical shape.

Autoimmune conditions like lupus can lead to acquired forms of hemolytic anemia. In lupus, the body can begin to attack and break down its own red blood cells. Certain forms of mono and pneumonia may also cause the disease, as can septic shock and malaria. High doses of penicillin have been indicated in causing short bouts of hemolytic anemia, and many illegal drugs can also create this blood abnormality. Blood transfusion that is RH incompatible may temporarily induce hemolytic anemia.

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The main symptoms of hemolytic anemia are fatigue, and in advanced cases heart failure. Blood clotting time can be affected and people may have a high incidence of bleeding after injury or after surgery. People with hemolytic anemia may also look jaundiced. Tests for the condition include blood smears to evaluate whether there are a high number of fragments of blood cells, and analysis of bilirubin levels. Depending upon the cause of the condition, further tests may be used to evaluate underlying causes like autoimmune disorder or presence of disease.

Treating the underlying cause of hemolytic anemia is usually the first step in curing the condition. Additional treatments may be indicated by severity of symptoms. These can include blood transfusions, or steroid treatment. In some cases, people with the condition must undergo a splenectomy, removal of the spleen, since it can be indicated in causing the quick death of red blood cells.

A rare form of hemolytic anemia, called erythroblastosis fetalis, can occur in newborns and is normally caused by the mother having a negative blood type that conflicts with the baby’s positive blood type (called Rh incompatibility). This is usually prevented by the mother receiving a special vaccination after giving birth to her first child to prevent Rh incompatibility with future children. When this is not prevented, this form of hemolytic anemia can be very severe for the newborn, resulting in brain damage. Knowledge about blood types and their effect on the fetus have now made this condition rare in developed countries.

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