Hemolytic anemia

As Hemolytic anemia refers to all forms of anemia in which the red blood cells do not reach their normal life span.

Causes

A distinction as causes changes in the blood itself ( corpuscular cause) and of the blood cells independent causes ( extrakorpuskuläre cause). The corpuscular causes include defects of the erythrocyte membrane as the ball -cell anemia or elliptocytosis, erythrocyte enzyme defect such as glucose-6 -PDH deficiency or pyruvate kinase deficiency and paroxysmal nocturnal hemoglobinuria.

The extrakorpuskulären causes include Immunhämolysen (destruction of red blood cells by their own or other defenses), mechanical ( eg heart valve replacement ), toxic- drug-induced causes (eg snake venoms ) and infectious diseases (eg feline infectious anemia)

Clinical manifestations and diagnosis

Shown are the usual symptoms of anemia, such as derating, weakness, rapid fatigue, dizziness, tinnitus, pallor of skin and mucous membrane and possibly with an increase in indirect bilirubin in the blood, yellowing of the skin and sclerae. The bile pigment is relying more and more excreted in feces and urine, which is why both the possibility to have a dark color. Diagnosis, in particular an increase in the reticulocyte count, a polychromasia and an increase in erythroblasts in the bone marrow are groundbreaking.

Course

To a decrease in the number of red blood cells in the blood occurs when their degradation is accelerated so much that he can no longer be offset by increased production in the red bone marrow. The number of reticulocytes is therefore typically increases also, the iron content of the blood and the spleen is often the same reason enlarged ( splenomegaly).

Therapy

The treatment generally depends on the cause. In corpuscular forms may be appropriate in many cases symptomatic a splenectomy. In extrakorpuskulären forms which are triggered by autoantibodies, a corticoid example, is used (eg, prednisolone ) and infection- related (eg as part of a malaria tropica ) a specific treatment of the causative disease is necessary.

In cases of severe anemia may be symptomatic administration of allogeneic blood ( blood transfusion ) are necessary, the use of erythropoietin should be handled restrictively because of the high risk of side effects.