Note
You are in a sub-theme of the Anemia section. You can find general information on this topic under: Anemia
Introduction
Hemolysis is the dissolution of red blood cells. This happens naturally after 120 days of life of a red blood cell. However, increased and premature degradation is pathological and, if the rate of degradation is higher than the rate of new formation, which can be increased to compensate, leads to anemia.
Symptoms
In addition to the general signs of anemia, those affected suffer from a yellowing of the skin and conjunctiva of the eye (icterus). Normally, the breakdown of old red blood cells takes place in the spleen. Therefore, an increased breakdown over a longer period of time can lead to an enlargement of the spleen (splenomegaly). A hemolytic crisis can occur in the event of serious infections or surgery. The crisis is characterized by a massive yellowing of the skin, fever and pain.
Causes and forms
Causes of hemolytic anemia are
- Defects in the membrane structure of red blood cells (e.g. spherical cell anemia (hereditary spherocytosis), elliptocytosis, marchiafava anemia)
- Disturbed metabolism in the cells (enzyme defects such as glucose-6-phosphate dehydrogenase deficiency, pyruvate kinase deficiency)
- Disorders in hemoglobin structure (e.g. sickle cell anemia)
- Poisoning, drugs, chemicals, radiation, etc.
- Autoimmune antibodies
- Antibodies that are active at certain body temperatures
- Antibodies after mistransfusion
- As a result of bone marrow transplantation
Antibody-induced hemolysis
In antibody-induced hemolysis, the body produces antibodies that are directed against the red blood cells and lead to their destruction. This antibody formation can be induced by drugs or infections. Often these are heat autoantibodies.
These bind to the red blood cells at body temperature and then lead to their destruction in the spleen or liver. The heat autoantibodies can be detected with the so-called Coombs test. Corticosteroids are used in therapy.
Taking some drugs stimulates the formation of antibodies directed against red blood cells. There are several drugs that can lead to hemolytic anemia. However, the drugs rarely trigger hemolytic anemia.
The drugs include non-steroidal anti-inflammatory drugs (NSAIDs). This group of drugs includes various painkillers such as ibuprofen. Certain antibiotics can also lead to hemolytic anemia in rare cases.
These include penicillin and cephalosporins. Another drug is alpha-methyldopa, which is used to treat high blood pressure in pregnant women. Cold antibodies are antibodies produced by the body that bind to red blood cells at low temperatures and lead to their destruction.
A distinction is made between the acute cold agglutinin syndrome, which usually occurs 2-3 weeks after an infection, and a chronic form. This can occur with lymphoma or without a recognizable cause. In this case one should protect oneself from cold. In the case of pronounced hemolytic anemia, immune suppressants can also be taken – i.e. drugs that suppress the immune system.
