Hemolytic anemia is anemia due to hemolysis , the abnormal breakdown of red blood cells either in the blood vessels (intravascular hemolysis) or elsewhere in the body (extravascular). The mechanism by which the immune system mistakes the red blood cells for a "foreign invader" varies somewhat according to the cause. It usually involves adherence of the offending agent (parasite, drug or toxin) to the surface of the red blood cells.Autoimmune hemolytic anemia can also be caused by or occur with another disease, such as systemic lupus erythematosus, and rarely it follows the use of certain drugs, such as penicillin. Though much attention has been given recently to AIHA due to evidence linking the process of vaccinating with the manifestation of this sometimes life-threatening disease, immunization is only one potential cause for this condition. In particular, a form of damaged red blood cell known as a spherocyte occurs. Finding spherocytes on a blood smear almost guarantees that some form of hemolytic anemia is occurring Blood transfusions can be used in dogs with IMHA if necessary but they can make the condition worse so most vets reserve this approach for dogs that appear to be in imminent danger of dying due to severe anemia. It is necessary to treat most dogs for a fairly long time to prevent recurrence of the disease and some dogs seem to require lifelong use of corticosteroids or other immunosuppressants. Splenectomy is done in resistant cases since it is a major site of red blood cell destruction.
Idiopathic autoimmune hemolytic anemia results from an abnormality of the immune system that destroys red blood cells prematurely. It has numerous possible causes, ranging from relatively harmless to life-threatening. The immune system wishes to attack the offending agent, but manages to injure the red blood cells as well. When the spleen and the rest of the immune system is working to rid the body of the old, diseased or damaged red blood cells, it is doing its job properly. Whenever hemolytic anemia is present it is wise to carefully rule out initiating causes that might be treatable. Examples of problems that can lead to hemolytic anemia include ehrlichiosis (a blood parasite), reactions to sulfa antiseptics or penicillin antibiotics, zinc toxicosis - which can occur due to the ingestion of pennies. In some people, the destruction may stop after a period of time; whereas in other people, it persists and becomes chronic. There are two main types of autoimmune hemolytic anemia: warm antibody hemolytic anemia and cold antibody hemolytic anemia. In acquired hemolytic anemia, the person develops the condition from some other cause. Hemolytic anemia can begin rapidly or come on gradually and can range from mild to severe.
Causes of Hemolytic Anemia
The common Causes of Hemolytic Anemia :
- Autoimmune disorders, such as systemic lupus erythematous (SLE, or lupus), rheumatoid arthritis, Wiskott-Aldrich syndrome, or ulcerative colitis
- Drugs such as penicillin, antimalaria medications, sulfa medications or acetaminophen
- surgery, radiotherapy, chemotherapy and/or immunotherapy...
- Blood loss excessive bleeding such as hemorrhages or abnormal menstrual bleeding.
- Penicillin and its derivatives .
- AIHA and hereditary spherocytosis are classified as examples of extravascular hemolysis because the RBCs are destroyed in the spleen and other reticuloendothelial organs.
- Hereditary spherocytosis.
Symptoms of Hemolytic Anemia
Some are common Symptoms of Hemolytic Anemia :
- Abnormal paleness or lack of color of the skin.
- Jaundice, or yellowing of the skin, eyes, and mouth.
- Pale color.
- Dark urine.
- Rapid heartbeat.
- Enlarged spleen.
- Heart murmur.
Treatment of Hemolytic Anemia
- your age, overall health, and medical history
- vitamin and mineral supplements
- extent of the disease
- Surgical removal of the spleen generally is reserved for children who do not respond to other therapies.
- Administer packed RBC slowly to avoid cardiac stress.
- Corticosteroid medications, which are synthetic versions of natural hormones produced by the body's adrenal glands
- Blood transfusions are given with caution, if indicated for severe anemia , because of the potential that blood may not be compatible and may bring on a reaction.
- corticosteroid medications
- splenectomy - surgery to remove the spleen.
- Administer folic acid because active hemolysis may consume folate and cause megaloblastosis.