Hemolytic Anemia

What is hemolytic anemia?

Hemolytic anemia is a type of anemia where there is increased destruction of red blood cells and the body is unable to replace red blood cells fast enough. The destroyed red blood cells get temporarily trapped in the spleen and lymph system and then are flushed from the body. The destruction of red blood cells can occur because of several inherited or acquired reasons. Causes of inherited hemolytic anemia include:

• Abnormalities in red cell membrane, such as the presence of hereditary spherocytosis or hereditary elliptocytosis
• Abnormalities in hemoglobin, such as unstable hemoglobins
• Deficiencies of red cell enzymes, such as G6PD, pyruvate kinase, glutathione, or other red cell enzymes

Acquired hemolytic anemia can be associated with:

• Certain viral or bacterial infections
• Medications, such as penicillin, sulfa, acetaminophen, or antimalarial medication
• Autoimmune disorders, such as systemic lupus, erythematosis, rheumatoid arthritis, or ulcerative colitis
• Certain cancers such as leukemia and lymphoma

What are the symptoms of hemolytic anemia?

The severity and type of symptoms is related to the degree of hemolytic anemia a child is experiencing. Symptoms may include:

• Confusion
• Dark-colored urine
• Dizziness
• Fatigue or muscle weakness
• Increased heart rate
• Pale skin, lips, or hands (in the nail bed)
• Yellowish tint to the eyes or skin

How is hemolytic anemia diagnosed?

It is very important that a complete history and physical examination be performed. This exam can provide valuable information about possible causes of the anemia as well as its effects on your child’s body. Many blood tests may be performed when a child is being evaluated for hemolytic anemia. For example, your child’s blood will be tested for hemoglobin, hematocrit and reticulocyte counts. A blood smear will be examined under a microscope to look at the number, size, and shape of red blood cells. Other blood tests may include hemoglobin electrophoresis (to look for an unstable hemoglobin), red blood cell enzyme levels, direct and indirect coombs (autoimmune hemolytic anemia) and/or an osmotic fragility test (assessing the red blood cell membrane.)

How is hemolytic anemia treated?

The treatment of hemolytic anemia depends upon the cause of your child’s condition and on how low your child’s hemoglobin is. Many people with hemolytic anemia have mild symptoms and do not require specific therapy. In some cases, avoiding certain medicines or foods can help minimize the severity of hemolysis. In some cases, hemolytic anemia requires a blood transfusion. A splenectomy (removal of the spleen) also may be considered.

About treatment of hemolytic anemia at Children’s Minnesota

Children’s Minnesota Cancer and Blood Disorders program achieves outcomes that rank among the top national programs and cares for more than 2/3 of Minnesota children and adolescents with blood disorders. In the program, families coping with hemolytic anemia have access to the newest and most promising treatments and receive care spearheaded and coordinated by a board-certified hematologist/oncologist.

Contact us

If you are a family member looking for a Children’s Minnesota hematologist or oncologist or wanting to schedule an appointment, call the outpatient clinic at Children’s Minnesota – Minneapolis at 612-813-5940. If you are a health professional looking for consultation or referral information, please call Children’s Minnesota Physician Access at 1-866-755-2121 (toll-free).