Hemolytic Anemia

If someone in your family or friend circle is complaining of tiredness, fatigue, and weakness without doing much physical activity, and his or her skin is turning steadily pale, then maybe it is an early indication of what is medically known as hemolytic anemia. The condition, if ignored, has the potential to cause major health trouble in the near future, and in some cases, you should be ready to hear death knells. Nobody, for no reason, is ready to die without knowing why he or she is going to die for a sickness that could have been easily surmounted with little knowledge and medical help. This illness is not the monopoly of people of any caste, creed, or gender. Anyone of any age from any place on the globe can be a victim due to a host of reasons and may suffer several types of anemia and fatalities.

Hemolytic Anemia

What is Hemolytic Anemia?

Hemolytic anemia is, in commoners’ words, a condition in which the red blood cells (RBC) in your blood die prematurely without giving a full performance of their 120-day natural life span. The phenomenon in which the red blood cells get destroyed is called “hemolysis” in medical language.

The RBC as well as the WBC (white blood cell) are naturally produced in the bone marrow. In a healthy person, the production and destruction equation is perfectly balanced, but in the case of hemolytic anemia, the equation is disturbed due to so many reasons, and production fails to meet demand in the bloodstream; hence, a person feels fatigued and weak.

A really weak problem in a normal case is readily treated with complete rest, taking an affordable regimen of supplemental medicines, and having sound sleep, but a person suffering from this sickness has reason to lose sleep and consult a medical professional at first blush. If not properly treated, the story will not end with weakness but will further drift into deadly channels of pain, an irregular heartbeat, abnormal enlargement, and failure of the heart in the end.

Anybody of any age at any time can become a victim of this ailment. The ailment in question affects more African-Americans than Caucasians, as revealed by the National Heart, Lung, and Blood Institute (NHLBI). It is a common observation that sickle cell anemia is more common among Africans and Americans.

Types of Hemolytic Anemia

Hemolytic anemia is classified into two types: inherited and acquired.

Inherited: In the case of inherited hemolytic anemia, the faulty genes that control the production of RBC are responsible for the disease. This case is hereditary and has been transferred to the children. This needs special care to combat the disease as the patient lives his or her life.

Acquired: In the case of acquired hemolytic anemia, you are lucky not to carry the defect in your genes (by birth), but not lucky afterward as you acquire it by some means. This type is indirectly treated by treating the diseases causing anemic conditions.

Hemolytic Anemia Causes

Premature destruction of RBC is the first cause. The RBCs are destroyed without living fully in the bloodstream and then removed from the blood as unwanted objects. Such destruction and removal of RBCs from the bloodstream are caused by so many factors, like some diseases, body conditions, and other factors. The causes of hemolytic anemia are divided into two major groups: intrinsic and extrinsic.

Intrinsic Causes: These are problems that start from within the body itself. It’s like the body’s own systems are causing the issue. Some intrinsic causes of hemolytic anemia include:

  • Inherited Conditions: Some people are born with genes that make their red blood cells fragile or easily breakable, causing them to break down faster than normal. These genes can be passed down from their parents.
  • Membrane Abnormalities: Red blood cells have a flexible outer membrane that allows them to move through blood vessels. Disorders affecting this membrane’s structure can lead to the cells being more prone to breaking.
  • Enzyme Deficiencies: Enzymes are like tiny helpers in our body. If a person doesn’t have enough of a certain enzyme, their red blood cells might not function well and could get destroyed.
  • Abnormal Red Blood Cell Shapes: Certain diseases, like sickle cell disease, cause red blood cells to have an unusual shape, making them more likely to break apart.

Extrinsic Causes: These are things outside the body that trigger the problem. Something from the outside is causing the red blood cells to break down. Some extrinsic causes of hemolytic anemia are:

  • Autoimmune Reactions: Sometimes, the body’s immune system mistakenly targets and destroys its own red blood cells, thinking they are invaders.
  • Infections: Certain infections, like malaria, can cause the body to destroy red blood cells as a way to fight off the infection.
  • Medications or Toxins: Some medicines or toxins can damage red blood cells directly or trigger immune responses that lead to their destruction.
  • Enlarged Spleen: The spleen is responsible for filtering the blood and removing damaged cells. If the spleen becomes enlarged due to various conditions, it might start to remove even healthy red blood cells.
  • Blood Clots: Sometimes, blood clots can block blood vessels and lead to the destruction of red blood cells as they pass through these clots.
  • Transfusion Reactions: In rare cases, when incompatible blood types are transfused, the immune system can destroy the transfused red blood cells.

Hemolytic Anemia Symptoms

The type and severity of the attack will determine what signs and symptoms of hemolytic anemia will appear in the patient. There are a few different types of hemolytic anemia, but they all share some common symptoms. These symptoms happen because your body is trying hard to make up for the lack of red blood cells. Let’s take a look at some of the signs you might notice if you have this disease.

Feeling Tired: One of the main symptoms of this illness is feeling really tired. That’s because your body is working extra hard to get enough oxygen to all your cells. When you’re low on red blood cells, your body can’t transport oxygen as well, and that can make you feel weak and exhausted.

Pale Skin: Your skin might look paler than usual if you have this illness. Red blood cells give your skin its healthy color, so when you’re low on them, your skin can lose some of its rosy glow.

Shortness of Breath: Since your body is struggling to get enough oxygen, you might find it harder to breathe. You might get out of breath more quickly, even when you’re doing simple things like walking or going up stairs.

Rapid Heartbeat: Your heart might start beating faster than normal. This is your body’s way of trying to pump more blood to make up for the lack of oxygen.

Dizziness or Lightheadedness: When you don’t have enough red blood cells, your brain might not be getting all the oxygen it needs. This may cause dizziness or lightheadedness.

Jaundice: Sometimes, hemolytic anemia can cause a condition called jaundice. When you have this illness, your skin and sclera, also known as the white of the eye, turn yellow. It happens because your body breaks down red blood cells and a substance called bilirubin builds up.

Dark Urine: Your urine might become darker than usual. This can also be because of the breakdown of red blood cells and the release of bilirubin.

Enlarged Spleen: The spleen is an organ that helps filter your blood. When you have this illness, your spleen might start working overtime to get rid of the damaged red blood cells. This can make your spleen get bigger, which is why you feel pain in the upper abdomen.

Pain: Some types of hemolytic anemia can cause pain in your belly or joints. This pain can come and go and might feel like a dull ache. In cases of sickle cell anemia, the cells in the shape of a farmer’s sickle choke the tiny blood vessels in the legs, causing leg sores and a painful body from top to bottom.

Transfusion Reactions: If transfused blood is of a different type, the hemolytic anemia so developed shows severe reactions in the form of chills, low BP, and a medical condition called shock, which is a medical emergency case needing immediate medical treatment.

Frequent Infections: Red blood cells also help your immune system fight off infections. If you don’t have enough of them, you might get sick more often.

Diagnosis of Hemolytic Anemia

Signs and symptoms such as a fast heartbeat, yellow skin, eyes, and lips, and a person complaining of tiredness without much physical effort are early indications of hemolytic anemia. The problem can be further deduced from a physical examination by your family physician. If required, you may be asked to undergo particular medical checks. Tests to diagnose hemolytic anemia include:

  • CBC (Complete Blood Count)
  • Hemoglobin in your RBC is full of iron-rich proteins and performs the task of taking oxygen to each and every cell of your body. The CBC test determines the number, size, and shape of the red blood cells. You are simply anemic if there is a low level of hemoglobin, as deduced by the CBC.
  • Additional Test
  • Once the CBC showed an anemic condition, the other following tests determined the type and severity of the anemia. The reticulocyte count measures the quantity of RBC production. Coombs’ test finds antibodies, which are responsible for the destruction of RBC. A liver function test determines the performance of the liver.
  • Urine Test
  • This test clearly tells you if there is a presence of free hemoglobin and iron in the urine sample.
  • Bone Marrow Test
  • The RBCs and WBCs are produced in the bone marrow. A healthy bone marrow will produce enough cells. To understand this performance, the expert needs a sample of the bone marrow. Aspiration and biopsy are the common tests to collect the marrow. Under local anesthesia to prevent feeling pain, usually in the posterior area or back of the hip or the iliac crest, the needle is pricked deep to draw a marrow sample, which is ultimately studied under a microscope to look for the faulty cells.

Hemolytic Anemia Treatment

Considering the severity and type of the disease, as well as the age, gender, and health condition of the patient, the treatment is suitably devised. For a mild case, no special treatment is needed. But in a severe case, you have to be prepared for a particular course of action, which may include medicines, blood transfusion, plasmapheresis, surgery, a blood and marrow stem transplant, and lastly, a major change in your lifestyle in case you have inherited the sickness from your parents.

Treatment Options for Hemolytic Anemia

The treatments for hemolytic anemia are as follows:

  • Blood Transfusion
  • In severe conditions, the best option is to go for a blood transfusion because the incoming supply of healthy blood quickly increases the RBC count and replaces destroyed blood cells with a renewed supply.
  • Medicines
  • The immune system is jolted down because of a low blood cell count; hence, infections can do more harm. Immunoglobulin given by IV (intravenous) in a hospital helps improve immunity, and the threat of infection is greatly controlled.
  • Plasmapheresis
  • This is again a hospitalization case. The affected blood is removed from the body using a needle inserted into a vein. The plasma containing antibodies is separated and replaced by the donor’s healthy plasma, and the same blood is pumped back into the system.
  • Surgery
  • An enlarged or diseased spleen, when unable to filter out damaged RBCs sufficiently and remove more than the required quantity of cells, needs to be removed; hence, surgery becomes necessary.
  • Blood and Marrow Stem Cell Transplant
  • The bone marrow fails to produce a sufficient number of healthy RBCs in thalassemia, a type of anemia. This necessitates a blood and marrow transplant, which replaces the defective cells with healthy cells from a donor.
  • Lifestyle Changes
  • When a patient is found to have AIHA with cold-reactive antibodies, any cold temperature condition gives rise to the breaking down of the RBCs. Therefore, it is necessary to avoid cold conditions, particularly on the tips of fingers, toes, and ears.

Hemolytic Anemia Prevention

Preventing hemolytic anemia requires embracing a healthy lifestyle and being proactive in mitigating the risk factors that could potentially contribute to the development of the condition.

To prevent hemolytic anemia, you can:

  • Balanced and Nutritious Diet: Eating a balanced diet with foods rich in iron and other nutrients helps in making enough red blood cells. Iron is a crucial component of hemoglobin, the protein in red blood cells that carries oxygen throughout your body.
  • Hydration: Drinking enough water keeps your body hydrated and supports the health of your red blood cells.
  • Infections: Avoiding infections, especially those that can affect the blood, helps prevent anemia. Regular vaccinations and proper hygiene play a role here.
  • Medications and Allergens: Some medications and allergies can trigger this disease in susceptible individuals. Knowing your allergies and discussing medications with a doctor can help prevent this.
  • Genetic Counseling: If hemolytic anemia runs in your family, talking to a genetic counselor can help you understand your risks and make informed decisions.
  • Avoiding Triggers: In some cases, certain foods, substances, or activities can trigger hemolytic anemia. Identifying and avoiding these triggers can help keep the condition under control.
  • Managing Underlying Conditions: If you have conditions like sickle cell disease or autoimmune disorders, proper management as advised by your doctor can prevent hemolytic anemia.
  • Blood Transfusions: In cases where the disease becomes severe and traditional prevention methods are not sufficient, receiving healthy red blood cells from a compatible donor can be a crucial treatment approach.
  • Prenatal Care: Pregnant women with certain blood disorders need extra care to prevent anemia in themselves and their unborn babies.
  • Hygiene and Safety: Infections and injuries can trigger a chain of events that impact the health of red blood cells, potentially contributing to the development of this condition. By prioritizing infection prevention and injury avoidance, you can significantly reduce the risk of factors that might lead to this illness.
  • Regular Check-ups: Regular visits to your doctor play a vital role in safeguarding your well-being and catching any signs of anemia early. These routine check-ups allow healthcare professionals to closely monitor your overall health, including the health of your red blood cells. By assessing your blood count, hemoglobin levels, and other relevant indicators, doctors can detect any abnormalities or potential anemia at an early stage. Early detection of anemia is essential as it enables timely intervention and management.


The disease is both treatable and preventable, but at the same time, it’s a potential killer. It is also manageable even if someone is suffering due to genetic inadequacy. The initial signs and symptoms must not be mistaken for workload, stress, or heavy travel. Once alerted, the immediate action is to consult the family physician and ask for his or her advice. Clear your doubts at once. If you are, by ill luck, bearing the disease, take it easy, go for the treatment, and follow the doctor’s advice. Even in cases of genetic problems, change your lifestyle to suit your health. This is sufficient to get cured. The medical expense is also not much. Inform your insurer about the ailment, the period of treatment, and the approximate expense. Discuss with your near and dear ones. Share your worries to lessen the emotional burden. No ailment on the face of the earth is incurable. Humans’ inherent strength enables them to face almost any challenge in life with their heads held high.


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