Mechanically induced hemolysis
In mechanically induced hemolysis, the red blood cells are mechanically destroyed by external influences. This can be done by an artificial heart valve or in hemodialysis, when the blood is passed through the dialysis machine for purification.
What is the diagnosis?
As always, diagnostics begins with a detailed doctor-patient consultation followed by a physical examination. To diagnose anemia, a blood test is essential. First of all, the hemoglobin is reduced, as in all anemias.
In addition, further parameters are collected. The destruction of the red blood cells increases the LDH (lactate dehydrogenase). Lactate dehydrogenase is an enzyme that is found in the red blood cells and can be measured in the blood as it is increased due to their destruction.
Serum iron is also elevated. In addition, the haptoglobin is measured. The haptoglobin binds the released hemoglobin until this complex is broken down by the spleen and liver.
Furthermore, the indirect bilirubin is increased. This is a breakdown product of hemoglobin. Depending on the presumed cause, further specific investigations are carried out.Hemolytic anemia is manifested by the following blood parameters:
- Haptoglobin decreased
- Indirect bilirubin increased
- LDH increased
- Free hemoglobin increased
- Increases urobilinogen in urine
- Reticulocytosis (increase in the number of young red blood cells)
- Enlargement of the haematopoietic bone marrow
- Depending on the type of anemia: altered shape of the cells (sphere, ellipse, sickle-shaped)
Life expectancy
It is not possible to make a general statement about life expectancy in hemolytic anemia. Life expectancy depends on the cause of the anemia. If these causes are curable, life expectancy is not limited.
On the one hand, there are various congenital defects of the red blood cells that lead to hemolytic anemia. Depending on the severity of the defect and treatment options, the course of the disease varies greatly and can be fatal in the worst case. Anemia can also be caused by physical and chemical damage or medication.
If the therapy is successful and the cause removed, life expectancy is not affected. Even antibody-induced hemolysis usually has a very good prognosis. In addition, there are rare microangiopathies (diseases of the small blood vessels), which cause anemia among other symptoms.
An early start of treatment is crucial for a good prognosis. The situation is similar if the cause is an infectious disease such as malaria. The general physical condition and age of the patient also play an important role.
An acute and rapid development of hemolytic anemia can lead to a life-threatening emergency situation. One speaks of a hemolytic crisis.
