Associated symptoms

The clinical picture of the symptoms depends on whether the affected person is a homozygous or heterozygous carrier. In the homozygous form, one can generally speak of the more severe form. Patients already suffer hemolytic crises and organ infarctions in childhood due to circulatory disorders.

A hemolytic crisis is a complication of hemolytic anemia. Hemolytic simply means that the blood dissolves and anemia means the resulting quantitative anemia. If a hemolytic crisis occurs, this refers to a massively excessive breakdown of red blood cells, which is usually due to viral infections.

It is a life-threatening condition with fever, chills, shock symptoms (including a drop in blood pressure, paleness, palpitations) and jaundice (“jaundice”). Here is an intensive medical care of need (see therapy). Also with homozygous carriers, organ infarcts can occur.

Vascular occlusions can occur all over the body. The most frequently affected organs are the spleen, the kidney, the central nervous system and the bones. The spleen, as an organ of blood breakdown, is particularly affected in hemolytic diseases.

If repeated vascular occlusions (infarctions) occur, the spleen increasingly loses its function and shrinks. The kidney as a filter organ can also be affected just as easily: this clinical picture then corresponds to “chronic glomerulonephritis” (permanent inflammatory condition of the smallest filter subunits of the kidney). With regard to bones, the femoral head (femoral head) and the humerus should be mentioned: like any other organ, they require an adequate blood supply.

If this is not ensured, aspecific bone necrosis occurs (death of the tissue without responsible pathogens). In the brain, a classic stroke can occur. The bone marrow is also affected by the altered form of the erythrocytes: for example, after an infection with the parvovirus B19 (ringworm), there can be a short-term shortage of erythrocytes.

The clinical picture of heterozygous carriers is quite different: in most cases, affected persons do not notice their disease, as it is milder. Only in extreme stress situations do they decompensate, which can be all the more dangerous when the disease first occurs. These physical states of emergency can be extreme sporting stress, pregnancy, surgery and, in particular, connection to a heart–lung machine. You can find out what other symptoms a hemolytic anemia has in our article Hemolytic Anemia!