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Hemolytic anemia.

Gurpreet Dhaliwal¹, Patricia A Cornett, Lawrence M Tierney

¹San Francisco Veterans Affairs Medical Center/University of California-San Francisco School of Medicine, San Francisco, California 94121, USA. gurpreet.dhaliwal@med.va.gov

American Family Physician

|June 19, 2004

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Hemolysis, a condition of premature red blood cell destruction, manifests as anemia or jaundice. Diagnosis involves specific blood tests and smear findings, with causes categorized as acquired or hereditary.

Area of Science:

Hematology
Pathophysiology

Background:

Hemolysis is characterized by premature erythrocyte destruction, leading to anemia, reticulocytosis, or jaundice.
Erythrocyte destruction can occur intravascularly or extravascularly, with diverse underlying etiologies.

Purpose of the Study:

To outline the diagnostic criteria for hemolysis.
To categorize the acquired and hereditary causes of hemolytic anemia.

Main Methods:

Diagnosis is established through laboratory findings including reticulocytosis, bilirubin and lactate dehydrogenase levels, haptoglobin levels, and peripheral blood smear analysis.
Etiologies are classified into acquired (autoimmunity, microangiopathy, infection) and hereditary (enzyme, membrane, or hemoglobin disorders).

Main Results:

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Acquired causes include immune-mediated hemolysis (secondary to various conditions), microangiopathic hemolytic anemia (characterized by schistocytes), and infections (e.g., malaria, babesiosis).
Hereditary causes encompass red blood cell enzyme deficiencies (e.g., glucose-6-phosphate dehydrogenase deficiency), membrane disorders (e.g., hereditary spherocytosis), and hemoglobinopathies (e.g., sickle cell anemia, thalassemia).

Conclusions:

Hemolysis presents with distinct clinical and laboratory findings.
Understanding the classification of acquired and hereditary causes is crucial for accurate diagnosis and management of hemolytic anemias.