– Hemolysis is the breakdown or destruction of red blood cells (RBCs) before their normal lifespan of about 120 days. This biological process could impair normal functionality of an individual since it causes oxygen deficiency and this will automatically lead to anemia.
🔅 Causes of Hemolysis
– Hemolysis can be caused by various factors, such as genetic disorders, infections, medications, toxins, or mechanical damage.
1) Genetic disorders
– They affect the structure or function of RBCs or hemoglobin, the protein that carries oxygen in RBCs. Examples of these disorders are sickle cell anemia, thalassemia, G6PD deficiency, and hereditary spherocytosis.
2) Infections
– Infections damage RBCs or trigger an immune response against them. Examples of these infections are malaria, babesiosis, sepsis, and hepatitis.
3) Medications
– Some medications may interfere with the production or survival of RBCs or cause an allergic reaction. Examples of these medications are penicillin, acetaminophen, quinidine, rifampin, and heparin.
4) Toxins
– Toxins in the body may poison RBCs or hemoglobin or cause oxidative stress. Examples of these toxins are lead, copper, snake venom, and carbon monoxide.
5) Mechanical damage
– The wear and tear effect from physical activities ruptures RBCs or exposes them to shear stress. Examples of these factors are artificial heart valves, hemodialysis, heart-lung bypass machines, and intense physical exercise.
🔅 Symptoms of hemolysis and hemolytic anemia
– Some of the symptoms or hemolysis and hemolytic anemia are:
• Fatigue, weakness, and shortness of breath.
• Pale or yellow skin and eyes (jaundice).
• Dark urine.
• Enlarged spleen.
• Gallstones.
• Leg ulcers.
• Increased heart rate and blood pressure.
• Chest pain and heart failure.
🔅 Diagnosis of hemolysis and hemolytic anemia:
– The diagnosis of hemolysis and hemolytic anemia involves:
1) A complete blood count (CBC)
This measures the number and size of RBCs and the level of hemoglobin and hematocrit (the percentage of RBCs in the blood).
2) A reticulocyte count
This test measures the number of immature RBCs in the blood. A high reticulocyte count indicates increased production of RBCs to compensate for hemolysis.
3) A peripheral blood smear
This examines the shape and appearance of RBCs under a microscope. Abnormal RBCs may suggest a specific cause of hemolysis.
4) A bilirubin test
This test measures the level of bilirubin in the blood. Bilirubin is a waste product from the breakdown of hemoglobin. A high bilirubin level indicates increased hemolysis.
5) A haptoglobin test
– This test measures the level of haptoglobin in the blood Haptoglobin is a protein that binds to free hemoglobin in the blood. A low haptoglobin level indicates increased hemolysis.
6) A lactate dehydrogenase (LDH) test
This test measures the level of LDH in the blood. LDH is an enzyme that is released from damaged cells. A high LDH level indicates increased cell destruction.
7) A direct antiglobulin test (DAT) or Coombs test
This is a test that detects antibodies or complement proteins that are attached to RBCs. A positive DAT indicates immune-mediated hemolysis.
• Other tests that may identify the specific cause of hemolysis, such as genetic tests, antibody tests, infection tests, drug tests, or toxin tests.
🔅 Treatment of hemolysis and hemolytic anemia
– The treatment of hemolysis and hemolytic anemia depends on the cause and severity of the condition. Some of the possible treatments are:
• Treating the underlying cause of hemolysis, such as infection, medication, toxin, or mechanical factor
• Avoiding triggers or factors that may worsen hemolysis, such as certain foods, drugs, chemicals, or activities
• Taking supplements or medications that may help increase RBC production or reduce hemolysis, such as folic acid, iron, vitamin B12, corticosteroids, immunosuppressants, or chelators.
• Receiving blood transfusions to replace lost RBCs and improve oxygen delivery to the tissues.
• Undergoing a splenectomy to remove the spleen if it is trapping and destroying too many RBCs.
• Undergoing a stem cell transplant to replace the faulty bone marrow cells with healthy ones from a donor if the cause of hemolysis is genetic and severe.
– Hemolysis is a serious condition that can affect the quality of life and health of people who have it. However, with proper diagnosis and treatment, hemolysis can be managed and controlled.
