Hemolytic AnemiaWhat is hemolytic anemia?Hemolytic anemia is a disorder in which the red blood cells are
destroyed faster than the bone marrow can produce them. The term for
destruction of red blood cells is "hemolysis." There are two types of
hemolytic anemia:
- intrinsic - the destruction of the red blood cells due to a
defect within the red blood cells themselves. Intrinsic hemolytic
anemias are often inherited, such as sickle cell anemia and thalassemia.
These conditions produce red blood cells that do not live as long as
normal red blood cells.
- extrinsic - red blood cells are produced healthy but are
later destroyed by getting trapped in the spleen, destroyed by
infection, or destroyed from drugs that can affect red blood cells. The
following lists some of the causes of extrinsic hemolytic anemia, also
called autoimmune hemolytic anemia:
- infections: hepatitis, cytomegalovirus (CMV), Epstein-Barr virus (EBV),
typhoid fever, E. coli, or streptococcus
- drugs: penicillin, antimalaria medications, sulfa medications, or
acetaminophen
- leukemia or lymphoma
- autoimmune disorders such as systemic lupus erythematous (SLE, or
lupus), rheumatoid arthritis, Wiskott-Aldrich syndrome, or ulcerative
colitis
- various tumors
Some types of extrinsic hemolytic anemia are temporary and resolve over
several months. Other types can become chronic with periods of remissions
and recurrence.
What are the symptoms of hemolytic anemia?
The following are the most common symptoms of hemolytic anemia. However,
each child may experience symptoms differently. Symptoms may include:
- abnormal paleness or lack of color of the skin
- jaundice, or yellowing of the skin and eyes
- dark color to urine
- fever
- weakness
- dizziness
- confusion
- intolerance to physical activity
- enlargement of the spleen and liver
- increased heart rate (tachycardia)
- heart murmur
The symptoms of hemolytic anemia may resemble other blood conditions or
medical problems. Always consult your child's physician for a diagnosis.
How is hemolytic anemia diagnosed?
Hemolytic anemia may be suspected from general findings on a complete
medical history and physical examination of your child, such as complaints
of tiring easily, pale skin and lips, or a fast heartbeat (tachycardia).
In addition to a complete physical examination, your child's physician may
order the following diagnostic tests:
- blood tests (to measure hemoglobin and reticulocyte count;
test that reveals how many new red blood cells are being produced)
- additional blood tests (to check liver function as well as
the presence of certain antibodies)
- urine tests
- bone marrow aspiration and biopsy - marrow may be removed by
aspiration or a needle biopsy under local anesthesia. In aspiration
biopsy, a fluid specimen is removed from the bone marrow. In a needle
biopsy, marrow cells (not fluid) are removed. These methods are often
used together.
Treatment for hemolytic anemia:
Specific treatment for hemolytic anemia will be determined by your child's
physician based on:
- your child's age, overall health, and medical history
- extent of the anemia
- cause of the anemia
- your child's tolerance for specific medications, procedures, or
therapies
- expectations for the course of the anemia
- your opinion or preference
The treatment for hemolytic anemia will vary depending on the cause of
the illness. Treatment may include:
- blood transfusions
- corticosteroid medications
- treatment with intravenous immune globulin (to strengthen the immune
system)
In more severe cases, the following treatments may be necessary and
usually require hospitalization:
- exchange transfusion (similar to a blood transfusion but with more
blood being given and an equal amount of the child's hemolyzed blood
being removed)
- surgical removal of the spleen (usually reserved for children who do
not respond to other therapies)
- immunosuppressive therapy
More Information
Schneider Children's
Hospital Division of Hematology/Oncology
Click here to view the
Online Resources page of this Web.
|