Hemolytic anemia.PPTVIP

Hemolytic anemia HA = decreased levels of erythrocytes in circulating blood (anemia) because of their acclerated destruction (hemolysis) A red blood cell survives 90 to 120 days (on average) in the circulation, therefore about 1% of human red blood cells break down each day. The spleen (part of the reticulo-endothelial system) is the main organ which removes old and damaged RBCs from the circulation. In health the breakdown and removal of RBCs from the circulation is matched by the production of new RBCs in the bone marrow. When the rate of breakdown increases, the body compensates by producing more RBCs, but if compensation is inadequate clinical problems can appear. Breakdown of RBCs can exceed the rate that the body can make RBCs and so anemia can develop. The breakdown products of hemoglobin will accumulate in the blood causing jaundice and be excreted in the urine causing the urine to become dark brown in colour. HEMOLYTIC ANEMIA Hemolytic anemia = reduced red-cell life span  Signs of hemolytic anemia: History Onset/ duration (hereditary versus acquired) History of fatigue or jaundice Abdomen pain / cholelithiasis (chronic hemolysis) Medications or food /ie fava bean/(may exacerbate enzyme deficiencies) Travel (consider infection) and infection Vascular / cardiac surgery Blood loss or sequestration (increases reticulocytes in the absence of hemolysis) Discolored urine (intravascular haemolysis) Complete family history (jaundice, gallbladder disease, splenectomy, hereditary anaemia or other inherited diseases) Signs of hemolytic anemia: Physical Symptoms of anemia Jaundice Pallor Splenomegaly / hepatosplenomegaly Increased temperature Rapid pulse Laboratory futures (1) *Morfology: anemia *Peripheral blood smear microscopy: **fragments of the red blood cells (schistocytes) can be present **some red blood cells may appear smaller and rounder than usual (spherocytes) **reticulocytes are present in elevated numbers. **erytroblasts can be present.