Hemolytic Anemia: Symptoms, Treatment, and Causes (2023)


What is hemolytic anemia?

Hemolytic anemia is ablood disorderthat makes youRed blood cellsthey break down or die faster than your body can replace them with new blood cells. People can develop hemolytic anemia due to genetic conditions that cause anemia. People sometimes have mild symptoms of hemolytic anemia that go away after treatment. Health professionals can often cure hemolytic anemia after finding out what caused the condition. However, if left untreated, severe hemolytic anemia can cause serious heart problems.

What type of anemia is hemolytic anemia?

There are many different types of anemia. Hemolytic anemia occurs when red blood cells break down or die faster than normal. Red blood cells normally live for about 120 days. When they break down or die before then, your bone marrow doesn't have time to make enough new red blood cells, leaving you with a low red blood cell count. Other types of anemia can occur when:

  • An injury or illness causes excessive bleeding that drains the supply of red blood cells faster than the body can replace it.
  • Something affects the production of red blood cells, so your body makes fewer red blood cells or makes abnormal red blood cells.

Hemolytic anemia is less common than anemia caused by excessive bleeding or slow production of red blood cells.

What happens if hemolytic anemia is not treated?

Severe hemolytic anemia can lead to serious heart problems, includingarrhythmia(abnormal heart rhythm),cardiomyopathymiheart failure.

(Video) Hemolytic Anemia, Causes, Signs and Symptoms, Diagnosis and Treatment.

Who is affected by hemolytic anemia?

There are several types of hemolytic anemia, and each of them can affect people of all ages, races, and genders.

What is the difference between hemolytic anemia and autoimmune hemolytic anemia?

Autoimmune hemolytic anemia (AIHA)It occurs when your immune system mistakes red blood cells for foreign or unwanted substances. Your body reacts by producing antibodies that destroy red blood cells, causing anemia. Different factors can cause hemolytic anemia, including hereditary conditions, infections, and some medications.

Symptoms and Causes

What causes hemolytic anemia?

Hemolytic anemia can be caused by inherited conditions that affect red blood cells. It is also caused by certain infections or if someone receives a blood transfusion from a donor whose blood type is not a match.

What hereditary conditions can cause hemolytic anemia?

Some common hereditary conditions are:

(Video) Hemolytic Anemia

  • sickle cell anemia: In this disease, your body makes abnormally shaped red blood cells that get stuck in small blood vessels, the spleen, or the liver.
  • thalassemiaThis is another group of inherited blood disorders that cause your body to make abnormal red blood cells that are easily destroyed.
  • G6PD deficiency: To begenetic disorderit affects an enzyme that protects red blood cells. When the level of this enzyme drops, blood cells exposed to certain infections or medications are likely to break down.

What infections can cause hemolytic anemia?

Infections related to hemolytic anemia include:

  • Malaria: This disease occurs when mosquitoes infected with small malaria parasites bite people and leave parasites in the person's bloodstream. If left untreated, malaria can cause hemolytic anemia.
  • Rocky Mountain spotted fever:This infection spreads whenticksinfected with bacteriaRickettsia rickettsibite people.
  • Haemophilus influenza disease: These are infections caused by bacteria.H. complaint.
  • Human immunodeficiency virus (HIV):This virus causes acquired immunodeficiency syndrome (AIDS).

What medications can cause hemolytic anemia?

Some people develop hemolytic anemia while taking certain medications. Not everyone who takes these drugs will develop hemolytic anemia. Your doctor will review your medical history and current problems to make sure you can take these medicines. These medications include:

  • Penicillin: This antibiotic treats infections and other serious medical conditions.
  • Quinine:This medicine treats malaria.
  • Methyldopa: This medicine treats high blood pressure.
  • Sulfonamides: This is an antibacterial drug.

What are the symptoms of hemolytic anemia?

Hemolytic symptoms can be mild or more severe. They can also appear suddenly or develop over time. Typical symptoms include:

  • Jaundice:This condition affects the skin, the whites of the eyes (sclera), and mucous membranes, turning them yellow. This happens when you have a high bilirubin level caused by a breakdown of red blood cells.
  • Shortness of breath (dyspnea):This happens when you don't have enough red blood cells that carry oxygen throughout your body.
  • Fatigue:Fatigue is a feeling of being so tired that it affects your daily life and your ability to do your daily activities.
  • Fast heart rate (tachycardia):This condition means that your heart is beating faster than it should. When your heart beats too fast, there isn't enough time between beats for it to fill with blood, and your heart can't supply your body with the oxygen it needs.
  • low blood pressure(hypotension):Low blood pressure can be a symptom or a condition. It occurs when your blood pressure is much lower than expected.
  • blood in your urine(hematuria):This can be a symptom of sickle cell disease.
  • enlarged spleen orliver: The liver and spleen filter red blood cells as the cells move through the body. Damaged or dying red blood cells become trapped in the spleen and liver, destroying the cells. A larger than normal spleen or liver could be a sign that your red blood cells are damaged.

Can anemia be a medical emergency?

Acute anemia can be a symptom of sudden, severe blood loss or a sign that red blood cells are being destroyed too quickly. People with acute anemia may experience the following symptoms:

  • They are very weak.
  • Their hearts are beating very hard and fast.
  • They have trouble catching their breath.

Diagnosis and Tests

How do you know if you have hemolytic anemia?

Health professionals diagnose hemolytic anemia by:

  • Ask about your medical history, specifically if your family members have anemia.
  • Ask if you have certain infections or if you are taking certain medications that can cause hemolytic anemia.
  • Perform a physical exam focusing on signs and symptoms of anemia, jaundice, or if your spleen or liver is enlarged.

What tests do health professionals use to diagnose hemolytic anemia?

Health professionals often use various blood tests to diagnose hemolytic anemia. They may also examine blood samples for genetic markers that could be signs of inherited conditions that cause hemolytic anemia. They will usually do preliminary blood tests to determine if your symptoms are caused by some type of anemia. TOcomplete blood count (CBC)it is one of the preliminary tests they can do. A blood count measures:

  • How many red blood cells, white blood cells, and platelets you have.
  • The size of your red blood cells.
  • Hemoglobin, the protein in the blood that carries oxygen throughout the body.
  • Hematocrit, which measures the amount of space red blood cells take up in the blood.

What other tests can health professionals do?

They may order additional tests to identify the type of anemia you may have. These are the tests providers use to diagnose anemia, including hemolytic anemia:

  • Coombs test (direct antiglobulin test): This test looks for autoimmune hemolytic anemia.
  • reticulocyte count: A reticulocyte count measures the number of immature red blood cells (reticulocytes) in the bone marrow. Health professionals measure reticulocytes to find out if your bone marrow is making enough healthy red blood cells.
  • haptoglobin tests: Haptoglobin is a protein that removes waste produced by damaged red blood cells. Low haptoglobin levels can be a sign of damaged red blood cells.
  • Lactate dehydrogenase (LDH): LDH is an enzyme in red blood cells. An elevated LDH level may be a sign of increased red blood cell destruction.
  • unconjugated bilirubin: When your red blood cells break down, they makebilirubin. This test measures the amount of bilirubin that is not being processed by the liver. This is unconjugated bilirubin. A high level of unconjugated bilirubin can be a sign that large numbers of red blood cells are being destroyed.
  • peripheral blood smear: Health professionals examine blood cells for signs of abnormalities, including size and shape.
  • hemoglobin electrophoresis: Health professionals use this test to analyze hemoglobin, a protein in red blood cells that helps cells carry oxygen throughout the body.
(Video) Autoimmune Hemolytic Anemia | Warm, Cold & Paroxysmal Cold Hemoglobinuria | Symptoms, Treatment

Management and Treatment

How do health professionals treat hemolytic anemia?

Health professionals treat hemolytic anemia based on the cause of your disease and whether you are experiencing severe symptoms. For example, if your doctor thinks you have severe anemia, he or she may order blood transfusions to stabilize your red blood cell count. They will then diagnose the underlying condition that is causing the anemia so that it can be treated.

(Video) Anemia, Causes, Signs and Symptoms, Diagnosis and Treatment


How do I reduce the risk of developing hemolytic anemia?

Hemolytic anemia can be caused by many factors, most of which cannot be controlled. For example, you can develop hemolytic anemia after sustaining an injury or inheriting certain conditions. However, you can reduce your risk of serious illness by talking to your doctor any time you develop symptoms that could be anemia.

Outlook / Forecast

What can I expect if I have hemolytic anemia?

Hemolytic anemia affects people in different ways. Sometimes hemolytic anemia is a symptom of a serious underlying medical condition that requires extensive treatment. Other times, hemolytic anemia occurs as a reaction to certain infections and medications. In such cases, healthcare professionals cure the condition by treating the underlying infection or by changing the medication.

living with

How do I take care of myself?

Health professionals can cure your hemolytic anemia. Once you feel better, you may be interested in learning how to take care of your health to prevent another bout of illness. Some suggestions that can help you manage anemia include:

  • Eat a healthy diet rich in vitamins B12, C and B9 (folic acid). Ask to speak to a nutritionist if you want more information on ways to keep your red blood cells strong.
  • Drink plenty of water to stay hydrated.
  • Exercise regularly. Talk to your doctor about ways to exercise safely.
  • Avoid infections by washing your hands and avoiding people when they are sick.
  • Keep track of your symptoms by writing them down.
  • Talk to your doctor about any change in symptoms.

A note from the Cleveland Clinic

Hemolytic anemia occurs when something destroys red blood cells. This condition could be a sign that you have an inherited medical condition or a medical problem caused by an infection. You may be reacting to specific medications. Regardless of the cause, your doctor will focus on finding and treating the underlying cause. Prompt treatment often makes the difference between getting better or getting worse. The symptoms of hemolytic anemia may seem like less serious conditions. You know your body best, including how long it takes to recover from everyday illnesses. Talk to your doctor whenever you are concerned about changes in your body that will not go away.

(Video) Anemia - Causes, Symptoms, Treatments and Prevention


How do you treat hemolytic anemia symptoms? ›

Treatments for hemolytic anemia include blood transfusions, medicines, plasmapheresis (PLAZ-meh-feh-RE-sis), surgery, blood and marrow stem cell transplants, and lifestyle changes. People who have mild hemolytic anemia may not need treatment, as long as the condition doesn't worsen.

What is the best treatment for hemolytic anemia? ›

Treatment options may include: Blood transfusions: To help to increase the number of available red blood cells to carry oxygen to the body tissues. Corticosteroids: Such as Prednisone can suppress an overactive immune system. This limits the destruction of the red blood cells.

What are the major symptoms of hemolytic anemia? ›

What are the symptoms of hemolytic anemia? Your symptoms may include tiredness, dizziness, weakness, and a spleen or liver that is larger than normal.

What are the two main causes of hemolytic anemia? ›

Two common causes of this type of anemia are sickle cell anemia and thalassemia. These conditions produce red blood cells that don't live as long as normal red blood cells.

Can you fix hemolytic anemia? ›

Sometimes, people have mild hemolytic anemia symptoms that go away after treatment. Many times, healthcare providers can cure hemolytic anemia after finding out what caused the condition. Left untreated, however, severe hemolytic anemia can cause serious heart trouble.

What is the first line treatment for hemolytic anemia? ›

Glucocorticoids, such as prednisone, are usually the first line of treatment in autoimmune hemolytic anemia (AIHA). Consult a hematologist to individualize therapy and determine whether other forms of therapy are indicated in the treatment of AIHA. Taper glucocorticoids very gradually to avoid a relapse of hemolysis.

How long does it take to recover from hemolytic anemia? ›

Recovering from haemolytic anaemia treatment does not take long. People can recover and get back into their normal lives after four to five weeks of treatment.

What drugs can cause hemolytic anemia? ›

Drugs that can cause this type of hemolytic anemia include:
  • Cephalosporins (a class of antibiotics), most common cause.
  • Dapsone.
  • Levodopa.
  • Levofloxacin.
  • Methyldopa.
  • Nitrofurantoin.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Penicillin and its derivatives.
Jan 19, 2021

Does B12 help hemolytic anemia? ›

Vitamin B12 deficiency can lead to ineffective erythropoiesis and intramedullary hemolysis. In one cohort of patients with vitamin B12 deficiency, it led to severe anemia defined as Hgb < 6 g/dL in 2.5% of the patients and hemolytic anemia in 1.5% of the patients [3].

What virus causes hemolytic anemia? ›

The following lists some of the causes of extrinsic hemolytic anemia, also called autoimmune hemolytic anemia: Infections: hepatitis, cytomegalovirus (CMV), Epstein-Barr virus (EBV), typhoid fever, E. coli, or streptococcus.

What does hemolytic anemia feel like? ›

A Severe Reaction to a Blood Transfusion

You may develop hemolytic anemia due to a blood transfusion. This can happen if the transfused blood is a different blood type than your blood. Signs and symptoms of a severe reaction to a transfusion include fever, chills, low blood pressure, and shock.

What organ is affected by hemolytic anemia? ›

Bone marrow is the soft tissue in the center of bones that helps form all blood cells. Hemolytic anemia occurs when the bone marrow isn't making enough red cells to replace the ones that are being destroyed. There are several possible causes of hemolytic anemia.

Who is most at risk for hemolytic anemia? ›

The risk of autoimmune hemolytic anemia may be higher in those who have:
  • Been taking certain medicines.
  • Infections such as: Mononucleosis. Atypical pneumonia.
  • Certain cancers: Leukemia. ...
  • Collagen-vascular (autoimmune) diseases, such as systemic lupus erythematosus.
  • A family history of hemolytic disease.

What foods help hemolytic anemia? ›

Hemolytic anemia can cause you to feel more tired than usual. Eat a variety of healthy foods. This may help you have more energy and heal faster. Healthy foods include fruit, vegetables, whole-grain breads, low-fat dairy products, beans, lean meat, and fish.

Is hemolytic anemia a form of leukemia? ›

Abstract. Chronic lymphocytic leukemia (CLL) patients have a greater predisposition to develop autoimmune complications. The most common of them is autoimmune hemolytic anemia (AIHA) with a frequency of 7–10% of cases. Pathogenesis is multifactorial involving humoral, cellular, and innate immunity.

Can you live a long life with hemolytic anemia? ›

Introduction: Autoimmune hemolytic anemia (AIHA) is considered a chronic disease, with an overall good prognosis.

What autoimmune diseases cause hemolytic anemia? ›

The causes of autoimmune hemolytic anemia are poorly understood. It may be a primary disorder or secondary to an underlying illness, such as Epstein-Barr Virus, lymphoma, lupus, immunodeficiency disorders, rheumatoid arthritis, or ulcerative colitis.

What is the lifespan of hemolytic anemia? ›

At the end of their normal life span (about 120 days), red blood cells (RBCs) are removed from the circulation. Hemolysis is defined as premature destruction and hence a shortened RBC life span (< 120 days).

When should I go to the ER for hemolytic anemia? ›

Both intravascular and extravascular hemolytic anemias can present with similar symptoms. Emergency physicians should consider hemolysis in the differential when a patient presents with signs or symptoms of anemia such as fatigue, tachycardia, pallor, shortness of breath, or chest pain 1, 3, 5.

Can stress cause hemolytic anemia? ›

When cells experience oxidative stress, ROS, which are generated in excess, may oxidize proteins, lipids and DNA - leading to cell death and organ damage. Oxidative stress is believed to aggravate the symptoms of many diseases, including hemolytic anemias.

What drugs and food should be avoided in hemolytic anemia? ›

Foods and substances that may trigger hemolytic anemic in people with G6PD deficiency include fava beans, some medications such as sulfa drugs, and henna.

What are two examples for hemolytic anemia? ›

Types of inherited hemolytic anemia include:
  • sickle cell disease.
  • thalassemia.
  • red cell membrane disorders, such as hereditary spherocytosis, hereditary elliptocytosis and hereditary pyropoikliocytosis, hereditary stomatocytosis and hereditary xeocytosis.
  • pyruvate kinase deficiency (PKD)

What deficiency causes hemolytic anemia? ›

Pyruvate kinase deficiency is an inherited lack of the enzyme pyruvate kinase, which is used by red blood cells. Without this enzyme, red blood cells break down too easily, resulting in a low level of these cells (hemolytic anemia).

Which vitamin deficiency is hemolytic? ›

A deficiency of vitamin B12 can lead to megaloblastic anemia. Vitamin B12 is involved in DNA synthesis and red cell maturation. The deficiency of vitamin B12 can lead to hemolysis in up to 10% of the affected.

How much vitamin B12 to treat anemia? ›

The usual dose for: diet-related deficiency is 50 micrograms to 150 micrograms, taken once a day. B12 deficiency not caused by your diet is one to two 1,000 microgram tablets, taken once or twice a day – this is usually if you cannot have vitamin B12 injections.

What is the most common infectious cause of hemolytic anemia? ›

Warm agglutinin disease accounts for the majority of autoimmune hemolytic anemia and is generally mediated by IgG antibodies to the Rh system of erythrocytes. Pathogens associated with warm agglutinin disease include, HIV, hepatitis C and infectious mononucleosis.

What bacteria causes hemolytic anemia? ›

Hemolytic anemia is a prominent part of the clinical presentation of patients infected with organisms such as the Plasmodium sp., Babesia, and Bartonella, which directly invade the erythrocyte.

Is hemolytic anemia caused by Covid? ›

AIHA diagnosis in the setting of COVID-19 infection

The AIHA diagnosis is based on the detection of hemolytic anemia by Hb level and biochemical markers of hemolysis (often supported by blood smear and absolute reticulocyte count), followed by a demonstration of autoimmune pathogenesis by DAT.

What lab test confirms hemolytic anemia? ›

A standard workup for hemolysis includes lactate dehydrogenase (LDH), unconjugated bilirubin, and haptoglobin tests, as well as a reticulocyte count. Hemolysis is confirmed by increases in the reticulocyte count, LDH, and unconjugated bilirubin, along with decreased haptoglobin.

What are the neurological symptoms of hemolytic anemia? ›

Various neurological features in these disorders include intellectual disability, hypotonia, pyramidal tract signs, dyskinesias, ataxia, peripheral neuropathy, myalgias and progressive muscle weakness.

What labs show hemolytic anemia? ›

Laboratory test results that confirm hemolysis include reticulocytosis, as well as increased lactate dehydrogenase, increased unconjugated bilirubin, and decreased haptoglobin levels. The direct antiglobulin test further differentiates immune causes from nonimmune causes.

What autoimmune disease destroys red blood cells? ›

In hemolytic anemia, red blood cells in the blood are destroyed earlier than normal. Immune hemolytic anemia occurs when antibodies form against the body's own red blood cells and destroy them. This happens because the immune system mistakenly recognizes these blood cells as foreign.

What lifestyle changes for hemolytic anemia? ›

Lifestyle Changes

If you have cold-reactive autoimmune hemolytic anemia, stay away from cold temperatures. During cold weather, wear a hat, scarf, and a warm coat. When taking cold food out of the refrigerator or freezer, wear gloves. Turn down air conditioning or dress warmly while in air-conditioned spaces.

What cancers are associated with hemolytic anemia? ›

Approximately 15 cases of overt hemolytic anemia associated with cancer have been reported in the medical literature. The majority of these cases have been associated with metastatic carcinomas of the stomach and breast.

Can vaccines cause hemolytic anemia? ›

Other hematologic complications are uncommon. We report the case of a patient who developed immunoglobulin G (IgG)-mediated autoimmune hemolytic anemia (AIHA) after the Moderna COVID-19 messenger ribonucleic acid (mRNA) vaccine.

What foods should you avoid if you have hemolytic anemia? ›

Foods and substances that may trigger hemolytic anemic in people with G6PD deficiency include fava beans, some medications such as sulfa drugs, and henna.

Is hemolytic anemia a medical emergency? ›

The most pressing concerns for the emergency medicine physician are the acute hemolytic anemias that may cause immediate, life-threatening complications (4).

Is hemolytic anemia terminal? ›

Autoimmune hemolytic anemia (AIHA) is a rare immune disorder. It happens when your body mistakes red blood cells as foreign substances and attacks them. Treatments include medication, surgery or, in rare cases, a blood transfusion. AIHA is highly manageable, but can be fatal if left untreated.

What infection causes hemolytic anemia? ›

Microangiopathic hemolytic anemia occurs when the red cell membrane is damaged in circulation, leading to intravascular hemolysis and the appearance of schistocytes. Infectious agents such as malaria and babesiosis invade red blood cells.


1. Hemolytic Anemia ¦ Treatment and Symptoms
2. Hemolytic Anemia: What It Is and How to Treat It
(Heal With Samantha)
4. Sickle cell anemia - causes, symptoms, diagnosis, treatment & pathology
(Osmosis from Elsevier)
5. Anaemia 2, Causes, haemolytic and blood loss
(Dr. John Campbell)
6. Hemolytic Anemia Causes, Symptoms, and Diagnosis.
(British BioMedicine Institute)


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