Hemolytic Anemia: Everything You Need to Know About the Disease

The hemolytic anemia differs from that of the remaining anemia by hemolysis, that is, the red blood cells have a life span much shorter than usual.

The anemia is one of the hematologic disorders, the most common, being considered a public health problem, arising when there is an insufficient amount of red blood cells in the blood, and we are faced with a hemolytic anemia when the red blood cells are destroyed so early by rupture (hemolysis).

Anemia is defined by the World Health Organization as the values of hemoglobin (Hb) less than 12g/dL in women and less than 13g/dL in men.

In those without a hemolytic anemia, red blood cells last about 120 days before being discarded by the body. In the case of hemolytic anemia, the red blood cells are discarded before being replenished by the bone marrow.

This destruction of the red blood cells can be produced in the interior of the vessels through which they circulate – intravascular hemolysis – or in another part of the body – extravascular hemolysis.

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The causes of this type of anemia can be the following:

  • When the bone marrow cannot replenish the red blood cells that are being destroyed;
  • In the form autoimmune disease, the immune system erroneously identifying your own red blood cells as foreign bodies and starts attacking them. Although not always the cause to be clarified, can arise by deregulation of the immune system after an infection, presence of another autoimmune disease (for example, lupus, rheumatoid arthritis, among others), use of certain medications or even due to cancer;
  • The body can self-destroy their red blood cells due to certain genetic defects that cause the red blood cells to acquire abnormal forms;
  • Clots in the small blood vessels;
  • Infectious agents through the direct action of the toxins;
  • Blood transfusion from a donor with incompatible blood.


Usually, in this type of anemia the person initially is asymptomatic, and only when it reaches a value of hemoglobin very low is starting to develop the following symptoms:

  • Weakness or fatigue abnormal;
  • Difficulty concentrating and memory failures frequent;
  • Cephalalgia (headaches);
  • Nails fragile and brittle;
  • Hypotension;
  • Dizziness frequent;
  • Dyspnoea (difficulty in breathing);
  • Pale skin;
  • Paleness in the mucous membranes of the eyes and the mouth;
  • Tachycardia (heart rate > 100 beats per minute);
  • Decreased appetite;
  • Dry skin;
  • Hair loss;
  • In the most serious cases to check:
    • Haemoglobinuria (urine red / brown);
    • Jaundice;
    • Splenomegaly.

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The diagnosis is made through a combination of the symptoms described by the person and is confirmed by blood tests (complete blood count helps differentiate the type of anemia, evaluates the amount of red blood cells, hemoglobin and hematocrit). If these tests are not conclusive, we obtain hemossiderina urinary and haptoglobin in serum.

You should also do immune tests, such as the test de Coombs direct, evidence for the presence of antibodies bound to the surface of the red blood cells and tests that prove hemolysis, such as increased reticulócitos in the blood, which are red blood cells immature that appear in the bloodstream in excess in the case of hemolysis.

An examination that measures the longevity of red blood cells using the techniques of radio-tagging can also help diagnose hemolytic anemia.


It is essential to identify the cause of anemia, once your treatment will depend on this. The treatment may involve the following steps:

  • When the cause is auto-immune, the treatment includes the intake of drugs targeted at the immune system of the person (such as, for example, corticosteroids and imunosupressores);
  • Intake of folic acid and extra supplements of ironto help replenish the amounts that are being lost by the rapid destruction of red blood cells;
  • In some cases, may be indicated the removal of the spleen, called a splenectomy, since this is the location where part of the red blood cells are destroyed.
  • In emergency cases, blood transfusion.

The treatment time is variable, will depend on the guidance of the haematologist.

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