Understanding Acquired Hemolytic Anemias: Causes, Symptoms, and Management

What is it?

Acquired hemolytic anemia is a group of disorders in which red blood cells are destroyed faster than they are made. may be divided into two subgroups- non immune and immune hemolytic anemia. Immune hemolytic anemia, which is characterized by a positive direct coombs test, is divided into warm or cold antibody autoimmune hemolytic anemia and alloimmune hemolytic anemia. includes autoimmune hemolytic anemia . Warm antibody autoimmune hemolytic anemia consists of lupus and Evan’s syndrome. Cold antibody autoimmune hemolytic anemia include idiopathic cold hemagglutinin syndrome, infectious mononucleosis and mycoplasma pneumonia and paroxysmal cold hemoglobinuria. Alloimmune hemolytic anemia include hemolytic disease of the newborn, alloimmune hemolytic blood transfusion reaction, and drug induced immune mediated hemolytic anemia caused by high dose penicillin or methyldopa. The non-immune mediated hemolytic anemia, when direct Coombs test is negative, include drugs, toxins, trauma, mechanical, microangiopathic hemolytic anemia, infections and membrane disorders such as paroxysmal nocturnal hemoglobinuria and liver diseases.

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Additional names

This group contains additional names:
- Nonautoimmune Hemolytic Anemia
- Autoimmune Hemolytic Anemia
- Hemolytic-Uremic Syndrome

Signs & symptoms

Hemolytic anemias symptoms may include paleness, jaundice, dark urine, fever, weakness, dizziness, confusion, enlarged spleen or liver, tachycardia and a heart murmur.

Diagnosis

On a blood test, complete blood count may show anemia with low levels of hemoglobin, hematocrit, and red blood cells and high reticulocyte counts as well as signs for red blood cells breakdown- decreased levels of haptoglobin and increased levels of bilirubin. On a peripheral blood smear abnormal shapes of red blood cells may be detected. A direct Coombs test may be used to detect red blood cells antibodies. A urine test may show the presence of free hemoglobin. Other tests can be done for further evaluation.

Treatment

Treatment for hemolytic anemia depends on many factors, and ofcourse- the underlying cause. Treatment may include blood transfusions, corticosteroids, rituximab, and IVIG to strengthen the immune system. In severe cases, a splenectomy may be necessary as well as immunosuppressive therapy.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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Source of Information - We analyze big data of more than 23 million patients de-identified medical records from the following sources:

National Institution of Health ∙ World Health Organization ∙ University of Illinois hospital