Diagnosing & Treating Hemolytic Anemia

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Red blood cells transport oxygen throughout the body. When you have anemia, you don't have a sufficient number of healthy red blood cells. When you have hemolytic anemia, red blood cells are destroyed faster than usual. Some cases of hemolytic anemia are chronic and slow, while others can be life-threatening.

This article will cover the causes of hemolytic anemia in children and adults, symptoms, the three different types, and the most common treatment methods used.

Doctor holding blood in test tube

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What Causes Hemolytic Anemia?

Your body makes new red blood cells in the bone marrow, the soft tissue in bones where all blood cells are formed. When you have hemolytic anemia, red blood cells are destroyed through a process called hemolysis.

There are several potential causes for hemolytic anemia, including:

Hemolytic Anemia in Children vs. Adults

Hemolytic anemia can affect both children and adults. The symptoms are similar for both age groups, but the cause of hemolytic anemia in children is more likely to be a viral infection.

One type of hemolytic anemia, called erythroblastosis fetalis, can occur in newborns when the newborn has a blood type that is incompatible with the mother's.

Symptoms

Not everyone with hemolytic anemia will have symptoms, especially if their case is mild. Common symptoms of hemolytic anemia include:

  • Breathing problems with physical activity
  • Fatigue
  • Feeling dizzy or light-headed
  • An irregular heartbeat
  • Yellowing of the eyes and skin (this is called jaundice)
  • Dark-colored urine

Other symptoms that may occur include:

These Symptoms May Not Indicate Hemolytic Anemia

The symptoms from hemolytic anemia may occur because of low blood counts or from the red blood cells getting destroyed in the body. These symptoms also resemble symptoms of many other health conditions, so having the symptoms does not necessarily indicate hemolytic anemia. You should always talk with your healthcare provider to help pinpoint what is causing your symptoms.

Types of Hemolytic Anemia

There are three types of hemolytic anemia: extrinsic, intrinsic, and erythroblastosis fetalis.

Extrinsic

The term "extrinsic" is used to describe hemolytic anemia caused by something other than the red blood cells themselves. Causes of extrinsic hemolytic anemia include:

  • Autoimmune diseases such as lupus or rheumatoid arthritis
  • Certain types of cancer like leukemia or lymphoma
  • Infections such as Epstein-Barr virus or hepatitis
  • The use of certain medications, such as penicillin, antimalaria medications, or Tylenol (acetaminophen), although not everyone using these medications will get hemolytic anemia

Intrinsic

When red blood cells get destroyed more rapidly because of a defect in the cells, this is called intrinsic hemolytic anemia.

Disorders that can lead to intrinsic hemolytic anemia include:

  • G6PD deficiency
  • Red cell membrane disorders
  • Sickle cell disease
  • Thalassemia

Erythroblastosis Fetalis

This is the name for hemolytic anemia in a newborn or fetus. It is caused by the destruction of red blood cells by maternal immunoglobulin G (IgG) antibodies.

In some people, hemolytic anemia is temporary. For others, it will occur and then recur chronically.

Diagnosis

A healthcare provider who suspects hemolytic anemia will ask you about your symptoms and perform a physical exam. Other tests you may need include:

  • A complete blood count (CBC): This is a type of lab test that measures your overall health through your blood. You may also have other blood tests, particularly if the complete blood count indicates that you have anemia.
  • Bone marrow aspiration (or bone marrow biopsy): This test will examine the number and size of your blood cells. It is done by removing a small sample of bone marrow fluid or solid bone marrow tissue.
  • Urine test: A urine test can be analyzed for hemoglobin and iron. Hemoglobin is a type of protein found in red blood cells.

Treating Hemolytic Anemia

Your healthcare provider will decide on the best treatment for your hemolytic anemia based on your age, medical history, and the severity of your anemia. Here is more information on some of the most common treatments used:

  • Red blood cell transfusion: This type of treatment will raise the number of red blood cells in your body, helping to offset the insufficiency caused by anemia.
  • Corticosteroids: This medication can help control an overactive immune system. Using corticosteroids for hemolytic anemia can potentially slow down red blood cell destruction.
  • Immune globulin (IVIG): This is an infusion containing antibodies that will slow down the destruction of red blood cells that is caused by hemolytic anemia.
  • Immunosuppressants: When your own immune system is destroying red blood cells, immunosuppressants can be an option. This may include medicines like Azasan (azathioprine) or Cytoxan (cyclophosphamide). It is used more frequently when other treatments do not work.
  • Surgery: A surgery called a splenectomy removes the spleen. A splenectomy may be used if red blood cell destruction is taking place in the spleen and if you are not responding to other treatments.

Summary

Hemolytic anemia is the name for a condition in which your body destroys red blood cells too quickly. It has several potential causes, including certain genetic disorders and autoimmune diseases. Symptoms may include fatigue and breathing problems.

A complete blood count and other diagnostic tests can help a healthcare provider determine if you have hemolytic anemia. Treatments include a red blood cell transfusion, IVIG, and immunosuppressants.

A Word From Verywell

It can be discouraging to experience symptoms of hemolytic anemia, especially since symptoms can indicate so many other health conditions. Keep in mind that although hemolytic anemia can be serious, it also is treatable. If you have hemolytic anemia, work with your healthcare provider to find the best treatment for you.

Frequently Asked Questions

  • Is hemolytic anemia curable?

    Yes, it can be curable with the right treatments. If you have an inherited form of hemolytic anemia, you may need treatments for it throughout your life. Some milder cases of hemolytic anemia do not require treatment.

  • What are the risks of living with hemolytic anemia?

    Without the right treatment, hemolytic anemia can cause serious heart issues. These include heart failure, cardiomyopathy (when the heart muscle has a hard time pumping blood to the rest of the body), and irregular heart rhythms.

  • What factors can increase the risk of hemolytic anemia?

    Having inherited blood disorders, such as sickle cell disease, can raise your risk of hemolytic anemia. Cancers like leukemia and lymphoma also increase hemolytic anemia risk. Having infections like Epstein-Barr virus (which causes mononucleosis) and autoimmune diseases like lupus also raise the risk for this type of anemia.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. U.S. National Library of Medicine. Hemolytic anemia. MedlinePlus.

  2. Cincinnati Children's Hospital. Hemolytic anemia.

  3. Children's Hospital of Philadelphia. Hemolytic anemia.

  4. Boston Children's Hospital. Hemolytic anemia.

  5. Britannica. Erythroblastosis fetalis.

  6. Johns Hopkins Medicine. Hemolytic anemia.

  7. National Heart, Lung and Blood Institute. Hemolytic anemia.

By Vanessa Caceres
Vanessa Caceres is a nationally published health journalist with over 15 years of experience covering medical topics including eye health, cardiology, and more.