Hemolytic-anemia overview and Definition


Disease overview:

Red blood cells have the important mission of carrying oxygen from your lungs to the heart and throughout the entire body. The bone marrow is responsible for making these red blood cells. When destruction of red blood cells excess its production , hemolytic anemia occurs.

 It occurs when the red blood cells are destroyed largely than they are manufactured.

Hemolytic anemia may be extrinsic and intrinsic.

Extrinsic hemolytic:

It develops by several methods, such as when the spleen traps and destroys the healthy red blood cells or an autoimmune reaction occurs. It can also come from the red blood cell destruction due to the following reasons:



Autoimmune disorders

Medication side effects




Intrinsic hemolytic:

The anemia develops when the red blood cells produced by the body doesn’t function properly. This condition is often inherited such as in people with the sickle cell anemia or thalassemia in which the person tends to have abnormal hemoglobin. An inherited metabolic abnormality can lead to this condition such as in people with G6PD deficiency or red blood cell membrane instability foe example hereditary spherocytosis. Anyone can develop hemolytic anemia


Hemolytic anemia is the destruction of the RBCs. The red blood cells has the lifespan of 120 days. When the red blood cell is unable to change the shape as it passes through the spleen, it becomes sequestered and phagocytosis occurs. This is seen in the hemoglobinopthies such as the sicke cell anemia. Damage can also occur with the inherited protein deficits such as membranopathies, hereditary spherocytosis, fragmentation, thrombocytopenic purpura , disseminated intravascular coagulation and increase in the oxidative stress or decrease in the energy production, antibodies binding with RBC’s resulting in phagocytosis. Drug induced hemolysis, infections or direct trauma.

Clinical signs & symptoms




Ischaemic symptoms

Differential Diagnosis

  • The blood test is help to diagnose the hemolytic  anemia  by :


  • Hemoglobin: This test reflects the amount of the red blood cells that circulating in the blood


  • Liver function test: This test measures the liver enzymes, and bilirubin in the blood


  • Reticulocyte count: This test measure the amount of the immature red blood cells which develops into the mature red blood cells over time the body isproducing.


  • Bilirubin:

The measures the level of hemoglobin content  that the liver has broken down.



  • Complete blood count (CBC):
  •  A CBC is used to count the number of blood cells in a sample of your blood. For anemia, your doctor will be interested in the levels of the red blood cells contained in your blood (hematocrit) and the hemoglobin in your blood.

Normal adult hematocrit values vary among medical practices but are generally between 40% and 52% for men and 35% and 47% for women. Normal adult hemoglobin values are generally 14 to 18 grams per deciliter for men and 12 to 16 grams per deciliter for women.

  • A test to determine the size and shape of your red blood cells(Peripheral blood smear)Some of your red blood cells might also be examined for unusual size, shape and color.
  • Serum iron and ferritin test-to check the amount of iron in blood and body
  • Reticulocyte test:to check that the bone marrow is functioning in an accelerated level
  • Haemoglobin electrophoresis:to check the abnormality of haemoglobin as seen in the sickle cell anaemia and thalassemia.
  • Osmotic fragility test: to check if the red blood cells are more fragile than usual
  • Endoscopy:to check for internal bleeding
  • Colonoscopy:to check for bleeding from tumour in the intestine
  • Ultrasound:to check for enlarged spleen
  • Doppler ultrasound:it detect the circulatory anomalies that is suggestive of anaemia  in new borns
  • Body Magnetic resonance imaging:It is used to reveal the functions of bone marrow and also it is used to find the deposition of iron in heart,liver and other vital organs.


The prognosis is excellent. The patient might take a time period of 2-6 weeks for complete recovery


Avoidance of the immunotherapeutic drugs

Avoidance of the unnecessary antibiotics like trimethoprim sulfamethaxone

Use of bioprothetic cardiac valves over mechanical valves to prevent valve induced hemolysis