all about hemolytic anemia

1. GASTROENTEROLOGY
HEMOLYTIC ANEMIA AND POST HEMORRHAGIC
SYNDROME

2. hemolytic anemia
• Red blood cells have the important mission of
carrying oxygen from your lungs to
your heartand throughout your entire body.
Your bone marrow is responsible for making
these red blood cells.
• When destruction of red blood cells outpaces a
person’s bone marrow production of these cells,
occurs.

4. classification
• Hemolytic anemia can be extrinsic or intrinsic.
• Extrinsic hemolytic anemia develops by several methods, such as
when the spleen traps and destroys healthy red blood cells or an
autoimmune reaction occurs. It can also come from red blood cell
destruction due to:
• infection
• tumors
• autoimmune disorders
• medication side effects
• leukemia
• lymphoma
• Intrinsic hemolytic anemia develops when the red blood cells
produced by your body don’t function properly. This condition is
often inherited, such as in people with sickle cell
anemia or thalassemia. Other times, a metabolic abnormality, such
as in people with G6PD deficiency, or red blood cell membrane
instability can lead to the condition.
• Anyone of any age can develop hemolytic anemia. However,
according to the National Heart, Lung, and Blood Institute
(NHLBI), hemolytic anemia seems to affect more African-
Americans than Caucasians. This is likely because sickle cell anemia
is more prevalent among African-Americans.

7. Causes of hemolytic anemia
• It’s possible that a doctor may not be able to pinpoint the source of
hemolytic anemia. However, there are several diseases and even
medications that can cause this condition.
• The following are some underlying causes of extrinsic hemolytic
anemia:
• enlarged spleen
• hepatitis
• Epstein-Barr virus
• typhoid fever
• E. coli toxin
• leukemia
• lymphoma
• tumors
• lupus
• Wiskott-Aldrich syndrome, an autoimmune disorder
• HELLP syndrome (named for its characteristics, which include
hemolysis, elevated liver enzymes, and low platelet count)

8. • Hemolytic anemia isn’t always due to an
autoimmune disorder. In some instances, it’s the
result of taking certain medications. This is known
as drug-induced hemolytic anemia. Some examples
of medications that could cause the condition are:
• acetaminophen (Tylenol)
• antibiotics, such as penicillin, ampicillin, or
methicillin
• chlorpromazine (Thorazine)
• ibuprofen (Advil, Motrin IB)
• interferon alfa
• procainamide
• quinine
• rifampin (Rifadin)

9. symptoms
• paleness of the skin
• fatigue
• fever
• confusion
• lightheadedness
• dizziness
• weakness or inability to do physical activity
• Other less common signs and symptoms that are seen in
those with hemolytic anemia include:
• dark urine
• yellowing of the skin and the whites of the eyes
(jaundice)
• heart murmur
• increased heart rate
• enlarged spleen

11. Hemolytic anemia in children
• According to the University of Chicago,
hemolytic anemia in children usually occurs
after a viral illness. The causes are similar to
those found in adults and include:
• infections
• autoimmune diseases
• cancers
• medications
• a rare syndrome known as Evans syndrome

12. DIAGNOSIS
• bilirubin, which is a test that measures the level
of red blood cells your liver has broken down
• hemoglobin, which is a test that measures the
amount of red blood cells you have
• liver function tests
• reticulocyte count, which is a test that measures
how many red blood cells your body is producing

13. Treatment
• options for hemolytic anemia may include:
• blood transfusion
• IVIG
• immunosuppressants
• corticosteroid medication
• surgery

14. • Blood transfusion
• A blood transfusion is given to quickly increase
your red blood cell count and to replace
destroyed red blood cells with new ones.
• IVIG
• You may be given immunoglobulin
intravenously in the hospital to blunt the body’s
immune system if an immune process is leading
to hemolytic anemia. Immunosuppressants may
be used to achieve the same goal.

15. • Corticosteroids
• In the case of an extrinsic form of hemolytic
anemia of autoimmune origin, you may be
prescribed corticosteroids. They can stop your
immune system from making antibodies that
destroy red blood cells.
• Surgery
• In severe cases, your spleen may need to be
removed. The spleen is where red blood cells are
destroyed. Removing the spleen can reduce how
fast red blood cells are destroyed. This is usually
used as an option in cases of immune hemolysis
that don’t respond to corticosteroids and
immunosuppressants.

16. POSTHEMORRHAGIC ANEMIA
• posthemorrhagic anemia or acute blood
loss anemia is a condition in which a person
quickly loses a large volume of circulating
hemoglobin. Acute blood loss is usually
associated with an incident of trauma or a severe
injury resulting in a large loss of blood. It can
also occur during or after a surgical procedure

17. symptoms
• Feeling weak, tired, dizzy, or lightheaded.
• A fast or irregular heartbeat.
• Pale or cold, clammy skin.
• Shortness of breath, or fast, shallow breaths.
• Nausea or loss of appetite.
• Urinating little or not at all.
• Trouble concentrating, or confusion.

21. diagnosis
• Your healthcare provider will examine you and ask about
your symptoms. You may also need any of the following:
• Blood tests are used to check the number of red blood
cells, white blood cells, and platelets. Platelets are the
sticky part of your blood that helps form clots to stop
bleeding. The tests may also be used to find how well
your blood can form clots.
• A urine or bowel movement sample may be tested
for blood.
• An endoscopy is a procedure used to check for
bleeding.

23. treatment
• Your healthcare provider may have you stop any medicines
that are causing bleeding. Treatment depends on the amount
of blood you lost, the cause of the bleeding, and your
symptoms:
• A blood transfusion may be needed if your body cannot
replace the blood you have lost.
• Surgery may be needed to stop the bleeding, or to fix an
injury.
• Fluids may be given through an IV to help increase your
blood pressure.
• Iron supplements may be given if your iron level is too low.
• Extra oxygen may be needed if your oxygen level is too low.