Hemolytic anemia is a group of disorders that cause a decrease in the mass of red blood cells due to their shorter life cycle. Unlike non-hemolytic anemias (such as those caused by iron deficiency), in hemolytic anemias the life span of red blood cells in peripheral blood (normal between 90 and 120 days) is shortened.
How can it be diagnosed?
An analysis called a hemogram or complete blood count (CBC) through which the number of red blood cells (RCC), hemoglobin and hematocrit (HCT) is determined, can help determine the type and cause of anemia that the patient suffers.
Causes of suffering from it during pregnancy
immune hemolytic anemia appears mainly during pregnancy, particularly when the baby’s blood type is different from that of the mother . Other reasons for which it can arise are infections, complications of diseases or reactions to medications.
The expectant mother is more fatigued, her heart rate increases, she has pale skin, cloudy urine, and shortness of breath. Although it is not serious, it should be treated.
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How does it affect the newborn?
Hemolytic disease of the newborn occurs when the mother produces antibodies that attack the red blood cells of the fetus. It is a consequence of the mother and child having different Rh blood types. Usually the mother is Rh negative and the fetus is Rh positive. It can cause serious difficulties if the red blood cells of the fetus come into contact with the mother’s blood. The baby may be born anemic and this influence its development , but such complications can be prevented.
Side effects during breastfeeding
Newborns with hemolytic anemia often have edema (swelling under the skin) and jaundice (yellow skin). Treatment recommendations include:
- Frequent feeding and hydration.
- Light therapy (phototherapy) that makes it easier for the baby to get rid of bilirubin.
- Supply of antibodies (intravenous immunoglobulin or IVIG) that will help protect the baby’s red blood cells.
- Medicines to raise blood pressure if it drops too low.
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How does it affect children, youth and adults?
The treatment of hemolytic anemia will vary from one child or young person to another depending on the cause of the disease and the severity with which it occurs. Some children may not even need treatment. All will require frequent blood tests to know the evolution of the disease. For those who require it, it may be necessary: periodic blood transfusions, medicines such as corticosteroids or steroids and to control the immune system, intravenous immunoglobulin (IVIG) and antibiotics.
What is its form of transmission? Is it hereditary?
There are two types of hemolytic anemias: hereditary and autoimmune.
- The inherited ones that are produced by genetic abnormalities within the blood cells (such as sickle cell anemia, thalassemia and glucose-6-phosphate dehydrogenase deficiency).
- Autoimmune diseases can be of unknown cause (idiopathic) in 2 to 4 out of 10 people, or secondary to other hematological and non-hematological diseases, in 6 to 8 of the people who suffer from it.
Check out our articles on ALL Autoimmune Diseases: Treatments, Types and Diagnoses
Some risks to consider
Some complications that can arise in the treatment of hemolytic anemia are:
- That blood cells are rapidly being destroyed and iron and folic acid supplementation is required.
- That the immune system becomes hyperactive, for which drugs are used to control it.
- That the spleen needs to be removed with surgery.
There are some typologies within it
There are three types of congenital hemolytic anemias :
- Red blood cell membrane disorders
- Enzyme disorders
- Alterations in hemoglobin
The Acquired are divided into:
- Mechanical: microangiopathic hemolytic anemias
- Physical agents
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Acquired from non-immune origin
It is suspected in patients with an anemic syndrome associated with jaundice and / or splenomegaly. They are usually of toxic or septic origin, or as a consequence of malaria or malaria.
Aplastic hemolytic anemia
Mixed or biphasic type autoimmune hemolytic anemia (AIHA) is characterized by the presence of autoantibodies.
Biphasic hemolytic anemia
Mixed or biphasic type autoimmune hemolytic anemia (AIHA) is characterized by the presence of autoantibodies (CAAs) called biphasic because their harmful action on red blood cells is exerted both at and below body temperature. It occurs in less than 10% of cases and can occur at any age, but is less common in children.
Congenital hemolytic anemia
Hemolytic anemia is one where the structure of the red blood cell presents alterations in its treatment, it is not recommended to supplement with iron since there are deposits of this trace element in the blood.
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Sickle cell or sickle cell anemia
Also known as sickle cell anemia, it is a hemoglobin SS (Hb SS) disease or sickle cell disease of hereditary origin and in which the red blood cells have an abnormal semilunar shape.
Intracorpuscular and extracorpuscular
Hemolytic anemias are classified into those intracorpuscular, which are congenital (from birth) and are due to the alteration in red blood cells (red blood cells) and those due to alterations in the blood vessels, which are known as extracorpuscular and are usually acquired. Intracorpuscular and extracorpuscular. Intravascular and extravascular.
Intravascular and extravascular
Intravascular or destruction of erythrocytes occurs mainly within the blood vessels and the extravascular occurs in the venous sinusoids of the spleen and other organs.
Macrocytic and microcytic hemolytic
Macrocytic anemia is known as a group of anemias characterized by red blood cells with a mean corpuscular volume (MCV) greater than 100 cubic microns, while microcytic anemia is characterized by small and pale red blood cells.
As maegaloblastic anemia, groups of diseases resulting from deficiencies of vitamin B12, folic acid, or both are known.
Read the following article and find out more about megaloblastic anemia
It is a hemolytic anemia that breaks down and destroys red blood cells while they pass through the blood, due to various types of mechanical trauma that take place in small blood vessels.
It comprises a large group of blood disorders composed of several inherited diseases, characterized by the deficiency of one of the enzymes involved in glycolysis (oxidation of glucose to obtain energy for the cell).
It is a type of anemia in which the bone marrow cannot meet the needs of red blood cells, as it does not produce them in sufficient quantity. It is due either to a decrease in erythropoietin (a protein that stimulates the production of red blood cells) or to damage to the marrow itself.
Normocytic and normochromic normocytic
Normocytic anemia is a disease in which red blood cells are missing, even though they are normal in size . It is related to chronic diseases such as bleeding, bone marrow problems or kidney ailments. Normochromic normocytic anemia is caused by sudden blood loss, prosthetic heart valves, general infection, tumors, long-term illness, or aplastic anemia.
Haemolytic or pernicious anemia
Pernicious anemia occurs from a decrease in the availability of red blood cells when the intestines cannot properly absorb vitamin B12.
Hemolytic by bacteria
Bacterial hemolytic anemia occurs when the available amount of red blood cells is reduced by the presence of bacteria. Of these, one of the most frequent is hemolytic uremic syndrome due to Escherichia coli; What happens when an infection in the digestive system produces toxic substances capable of destroying red blood cells. This causes injury to the kidneys.
By cold agglutinins
Cold antibody autoimmune hemolytic anemia (AIHA) is characterized by the presence of autoantibodies that bind to the red blood cell membrane at low temperatures and cause their early destruction.
Due to glucose 6 phosphate dehydrogenase deficiency
Glucose-6-phosphate dehydrogenase deficiency, or favism, is characterized by decreased activity of the enzyme glucose-6-phosphate dehydrogenase in red blood cells. It is the most common enzyme deficiency in the world and is an inherited disease linked to the X chromosome.
Due to pyruvate kinase deficiency
It arises from a congenital error in the metabolism of red blood cells, which causes chronic hemolytic anemia. Autoimmune disorders caused by autoantibodies.
Relationship with other diseases
With chronic lymphatic leukemia
Autoimmune disorders occur frequently in patients with chronic lymphocytic leukemia . In particular, a high percentage of patients develop autoimmune hemolytic anemia during the course of leukemia and this represents one of the main risk factors in advanced stages of the disease.
Hemolytic anemia and leukopenia
In hemolytic anemia, the red blood cells are cleared earlier than normal, while leukopenia is a lower-than-normal white blood cell count.
When it is linked to the X chromosome
The sideroblastic anemia is a disease in which the bone marrow produces sideroblasts (abnormal red blood cells as a consequence of the accumulation of iron granules) annealed instead of healthy red blood cells. Its origin may be in a genetic alteration or be an indirect consequence of myelodysplastic syndrome (a type of cancer).
Hemolytic anemia and lymphoma
In patients with lymphomas, anemia can occur due to different mechanisms such as bleeding, infection, nutritional deficiencies (iron, folates, vitamins), hemolysis, altered bone marrow function, activation of cytokines, chemotherapy, radiotherapy and as a consequence of the disease itself . About half of patients with multiple myeloma and one in 3 of those with lymphoma develop anemia.
If you are curious, check out our articles on:
If you are interested in knowing more about Anemia, we invite you to read this complete article with valuable information: Anemia: Risks, Causes, Treatments and Diagnoses
Articles on other types of anemia
We leave you a list with the articles of the other types of anemia that we have created, to make it easier to find information:
- Anemia: Risks, Causes, Treatments and Diagnoses
- Macrocytic Anemia: Medical and Natural Treatments, Causes and Diagnosis
- Hemolytic Anemia: Risks, Causes, Treatments and Diagnoses
- Iron Deficiency Anemia: Risks, Causes, Treatments, And Diagnoses
- Sickle Cell Anemia: Risks, Causes, Treatments, and Diagnoses
- Fanconi Anemia: Risks, Causes, Treatments, And Diagnoses
- Aplastic Anemia: Risks, Causes, Treatments, And Diagnoses
- Sideroblastic Anemia: Risks, Causes, Treatments, and Diagnoses
- Pernicious Anemia: Risks, Causes, Treatments, And Diagnoses
- Normocytic Anemia: Risks, Causes, Treatments, and Diagnoses
- Small Cell Anemia: Risks, Causes, Treatments, And Diagnoses
- Megaloblastic Anemia: Risks, Causes, Treatments, And Diagnoses
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