Hemolytic Anemia

Definition of Hemolytic Anemia

The definition of hemolytic Anemia

In a healthy body, red blood cells have life time of about 120 days before it is finally crushed and replaced by new red blood cells. Hemolytic anemia is anemia caused by the condition when red blood cells are destroyed prematurely. In the initial state, the spinal cord will try to overcome the deficiency of red blood by producing red blood cells faster. However, if the destruction of the red blood cells occurs continuously, the compensatory efforts of the bone marrow will fail and anemia. The condition of hemolytic anemia can be a mild condition, but can also be severe and life-threatening.

Risk Factors for hemolytic Anemia

Various risk factors of hemolytic anemia, among others:
  • Newborns.
  • Has an autoimmune disease history.
  • Have a family history with thalassaemia.
  • Receiving blood transfusions.
  • Taking medicines.

Causes of hemolytic Anemia

Hemolytic Anemia can be divided by the cause, namely decreased (hereditary) and obtained. The hemolysis or destruction of red blood cells in hereditary hemolytic anemia is usually caused by disruption or damage to the membrane, enzyme damage, or abnormal hemoglobin. Various causes of hereditary hemolytic anemia, among others:
  • Glucose deficiency in 6 phosphate dehydrogenase.
  • Thalassemia.
  • Hereditary sferocytosis.
  • Sickle cell anemia.
The cause of hemolysis obtained, among others
  • Immune system disorders, eg in the disease Lupus erythematosus.
  • Chemical substances and medicines (e.g. penicillins, Methyldopa, ribavirin).
  • Infection.
  • Blood transfusions are not suitable.
  • Erythroroblastosis Fetalis.

Symptoms of hemolytic Anemia

Mild hemolytic Anemia may not cause symptoms. In subsequent phases, the severity of the complaint is consistent with the amount of red blood cell deficiency in the body. Here are symptoms that tend to be common to many people with hemolytic anemia, such as:
  • Pale.
  • Limp.
  • Dizziness.
  • Easy to feel tired.
  • Low blood pressure.
  • Fever.
  • Rapid heartbeat.
  • Shortness of breath.
  • Chest pain.
  • Abdominal pain.
  • Skin discoloration.
  • The color of the urine becomes darker.
  • Enlarged liver.
  • Enlargement of the spleen.
  • Wounds on the feet.

Diagnosis of hemolytic Anemia

The Diagnosis of hemolytic anemia usually begins with questions related to the history and the perceived medical symptoms. In the process of checking the physical condition, the doctor begins to check the skin pale or yellow. The doctor will also do a gentle emphasis on the different areas of the patient's stomach to check for softness if there is enlargement on the liver or spleen.

If the doctor finds an indication of hemolytic anemia, further action will be performed, such as Blood screening which includes:
  • Full blood test
This examination is very useful to see the presence of anemia, infections that may be the cause of anemia or possible risk of blood disorders causing hemolytic anemia. In addition, reticulocyte examination can assess the increase in the production of red blood cells that can be an indication of hemolytic anemia. Blood samples will be taken and examined with special tools.
  • Edge blood cell screening
This examination can calculate the number of young blood cells, as well as abnormalities in the form and size of blood that can be associated with hemolysis anemia. This examination is done by taking blood samples and seen under the microscope for the examination of red blood cell form and size.

Serum lactate dehydrogenase (LDH), Haptoglobin Serum, and bilirubin Indirek
Increase in the level of LDH, changes in serum haptoglobin and increased levels of bilirubin Indirek can help doctors diagnose the condition and type of hemolytic anemia.
  • Screening examination for G6PD deficiency
  • Thalassaemia Screening Examination
  • Urine Test
  • Imaging Examination (ultrasonography, chest X-ray, and Electrocardiography)
Ultrasonography is used to see the size of the liver and spleen. Chest x-rays and electrocardiography are usually performed to evaluate the condition of the heart and lungs.
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Treatment of hemolytic Anemia

Treatment of hemolytic anemia can be done depending on several factors, such as the age of the elderly and the overall health and medical history. In addition, treatment is given according to the cause. Some of the things that the doctor will consider to choose the type of therapy are the levels and causes of the condition as well as tolerance for medications, procedures, and therapies.

Possible therapies can be administered in the treatment of hemolytic anemia, among others:
  • Folic acid therapy.
  • Corticosteroids. The introduction of corticosteroids is administered in hemolytic anemia with autoimmune diseases.
  • Intravenous immunoglobulin G.
  • Eryropoetin therapy. This therapy is administered in patients with renal failure.
  • No continuing consumption of drugs at risk of causing hemolytic anemia.
In some cases, individuals who have a high severity of hemolytic anemia require hospitalization and treatment as follows:

Blood transfusions. This therapy is usually administered to severe hemolytic anemia or with cardiac/pulmonary disorders, thalassaemia or sickle-cell disease. One of the side effects of this therapy is the buildup of iron in the body due to repeated transfusions. This condition can be improved with the therapy of iron molation.

Surgical removal of the spleen. This action is performed as an option in cases of hemolysis that does not respond to corticosteroids and immunosuppressants.

Prevention of Hemolytic Anemia

For the condition of hemolytic anemia derived from the elderly can not be prevented. However, it has an exception, such as the deficiency of glucose-6-phosphate dehydrogenase (G6PD).

If born with G6PD deficiency, it can avoid substances that can trigger the condition. For example, avoid fava beans, naphthalene (a substance found in some moths), camphor, and certain medications. There are also some types of preventable hemolytic anemia, such as reactions to blood transfusions that can cause hemolytic anemia. This requires matching a careful blood type between a blood donor and a recipient.

When to go to a doctor?

Immediately talk to the doctor if you, your family, or relatives have symptoms of hemolytic anemia previously discussed.

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