The Cause And How To Cure Hemolytic Anemia

Hemolytic Anemia is a condition in which destruction of red blood cells (erythrocytes) is faster than its formation. The occurrence of hemolytic anemia can be triggered by factors from within the red blood cells (intrinsic) and factors outside the red blood cell (extrinsic).

Hemolytic Anemia extrinsic is a hemolytic anemia caused by the response of the immune system which stimulate the spleen to destroy red blood cells. While hemolytic anemia intrinsic is a hemolytic anemia caused by red blood cells that are not ordinary. These conditions cause the red blood cells do not have the life-like cells ordinary. Hemolytic Anemia intrinsic generally genetically inherited like sickle cell anemia or thalassemia.

Hemolytic Anemia both extrinsic and intrinsic can appear in the short term (temporary) or appear as a chronic disease. Hemolytic Anemia temporary can be treated and disappear after a few months, whereas the hemolytic anemia of chronic can be suffered for a lifetime and lead to the occurrence of recurrence after a certain period of time.

Hemolytic Anemia can occur in anyone regardless of age, and can be caused by a variety of things. In the majority of patients, hemolytic anemia is only showing mild symptoms. While in some others, this condition requires intensive care throughout life.

The Cause Of Hemolytic Anemia

Some of the conditions that can result in the occurrence of hemolytic anemia intrinsic is:

1. Sickle-cell Anemia.
2. Talassemia.
3. Deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD).
4. Deficiency of the enzyme pyruvate kinase

While some of the conditions that can result in the occurrence of hemolytic anemia extrinsic is:

• Enlargement of the spleen.
• Viral infections Epstein-Barr virus and Hepatitis.
• Bacterial infections Coli, Salmonella typhi, and Streptococcus sp.
• Leukemia.
• Lymphoma.
• Tumors.
• Lupus.
• Syndrome Wiskott-Aldrich.
• HELLP syndrome.

Hemolytic Anemia extrinsic can also occur due to side effects of certain medications, such as:

• Paracetamol.
• Antibiotics, especially penicillin, ampicillin, and metisilin.
• Chlorpromazine.
• Ibuprofen.
• Interferon
• Procainamide.
• Quinine (quinine).
• Rifampin.

One of the main causes of hemolytic anemia weight is the error of blood transfusion where the blood group of the donor and recipient do not match. If the recipient donor is given blood that is not appropriate faction, then the antibodies contained in the blood plasma of the person will attack the red blood cells in the blood that is donated. This condition can cause damage to red blood cells in in the body.

There is also called hemolytic anemia mikroangiopatik, namely the conditions at the time of the red blood cells are fragmented. Some of the diseases that can cause these conditions are:

1. Disorders artificial heart valves.
2. Syndrome hemolytic uremia (SHU).
3. Thrombotic thrombocytopenic purpura (TTP).
4. Disseminated Intravascular Coagulation (DIC).

While in the newborn baby, there is a condition of hemolytic anemia called eritroblastosis fetalis. This condition occurs due to the incompatibility of rhesus blood group among pregnant women with a fetus. If a pregnant mother has a blood group is rhesus negative and the father of the fetus was type a rhesus positive, there is a possibility of the fetus in the womb has rhesus positive. These circumstances will cause the red blood cells of the fetus are attacked by antibodies from the mother's body. Case eritroblastosis fetalis generally occurs in the second pregnancy when the expectant mother already has the antibodies formed from the first pregnancy.

Disease hemolytic anemia quite dangerous for the baby due to complications from anemia. Currently, the treatment for babies who experience eritroblastosis fetalis is by administration of intravenous immunoglobulin (IVIG) or blood transfusion. The doctor can also prevent the emergence of eritroblastosis fetalis in pregnant women who are diagnosed with these conditions by giving the injection of RhoGAM at a gestational age of 28 weeks.

Symptoms Of Hemolytic Anemia

Symptoms of hemolytic anemia similar to anemia of other types. To distinguish it, need to do further diagnosis. Some of the symptoms of hemolytic anemia that often arises is:

• Pale skin.
• Fatigue.
• Fever.
• The head feels heavy and dizzy.
• Dizziness.
• Tired and can not perform strenuous physical activity.

While the other symptoms that may also appear in patients with hemolytic anemia is:

• Urine turned dark.
• The skin and whites of the eyes turn yellow.
• The heart feels rustled.
• The increased heart rate.
•  Enlargement of the spleen and liver.

The diagnosis of Hemolytic Anemia

The doctor will ask about symptoms, review the patient's medical history, and perform a physical examination as a preliminary step to analysis of hemolytic anemia.

At the time of the physical examination, your doctor will also check the color of the skin (especially if there is jaundice in the skin or in the whites of the eyes). After that the doctor will check the patient's abdomen to see any hardening or swelling as a sign of the growing organs of the liver and spleen.

If the patient is suspected to suffer from hemolytic anemia, the doctor will check the blood. Some of the parameters checked are as follows:

1. The number of blood cells total, in order to determine the number of blood cells in the patient.
2. Bilirubin, in order to determine the number of red blood cells are destroyed by the liver. In patients with hemolytic anemia, the concentration of non-conjugated bilirubin in the body is generally below zero,3 mg/L.
3. Hemoglobin, to determine the number of red blood cells that are still alive.
4. The number of reticulocytes, in order to determine the number of red blood cells produced by the body.

 The function of the liver.

Some additional tests that can help analysis of hemolytic anemia is:

• A urine test, to detect the presence of blood cells in the urine.
• A bone marrow biopsy, to determine the number of red blood cells which are produced along with the shape.
•  Staining of the blood (peripheral blood smear). Staining blood is used to view the shape of the blood cells through microscopic observation. Through this examination, the doctor can determine the maturity of blood cells, fragmentation of the blood cells, and so on. Staining of the blood can also detect whether a person is affected by sickle cell anemia or not seen from the shape of the red blood cells.
•  Studies of the enzyme lactate dehydrogenase. The enzyme lactate dehydrogenase is one of the important indicators in determining the presence of hemolysis in the patient. Patients suffering from hemolytic anemia can be diagnosed from elevated serum lactic dehydrogenase in the blood. Nevertheless, some malignant disease (cancer) can also increase serum levels of lactate dehydrogenase in the blood.
• Study of serum haptoglobin. Decreased serum haptoglobin in the blood can indicate the presence of hemolytic anemia secondary to heavy.

The Treatment Of Hemolytic Anemia

The treatment of hemolytic anemia will depend on the severity of anemia, age, condition of the patient's general health and tolerance of the patient to certain medications. The method of treatment of hemolytic anemia include:

• Blood transfusion. Blood transfusion aims to increase the number of red blood cells of the patient and replace blood cells damaged quickly.
• Intravenous immunoglobulin (IVIG). Lack of red blood cells can cause the patient more susceptible to infection. To prevent this, the patient will be given immunoglobulins through intravenous fluids.
•  Corticosteroids. On the patient of hemolytic anemia extrinsic which is caused by an autoimmune disease, corticosteroids function to suppress the response of the immune system so that red blood cells are not destroyed easily.
• Surgical removal of the spleen. The spleen is an organ that works to destroy red blood cells. In the case of hemolytic anemia are heavy and can not be solved with other methods of treatment, the spleen of the patient can be raised to reduce the damage of red blood cells.

For patients with hemolytic anemia who have been diagnosed by a doctor, please note the following things in order to live a normal activity, including:

1. Avoid direct contact with sick people, especially those affected by the disease infection.
2. Avoid crowds to reduce the risk of infection.
3. Routine hand washing.
4. Avoid consuming raw food.
5. Regular brushing your teeth.
6. To undergo flu vaccination every year regularly.

Complications Of Hemolytic Anemia

Some of the complications that can arise in patients with hemolytic anemia is:

1. Severity of anemia increased. In patients with hemolysis intravascular, iron deficiency due to hemoglobinuria chronic can aggravate anemia which have already appeared.
2. Jaundice (jaundice).
3. Heart failure.

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