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Hemolytic crisis

Hemolysis - acute

 

Hemolytic crisis occurs when large numbers of red blood cells are destroyed over a short time. The loss of red blood cells occurs much faster than the body can produce new red blood cells.

Considerations

 

During a hemolytic crisis, the body cannot make enough red blood cells to replace those that are destroyed. This causes acute and often severe anemia .

The part of red blood cells that carries oxygen (hemoglobin) is released into the bloodstream. This can lead to kidney damage.

 

Causes

 

Causes of hemolysis include:

  • A lack of certain proteins inside red blood cells
  • Autoimmune diseases
  • Certain infections
  • Defects in the hemoglobin molecules inside red blood cells
  • Defects of the proteins that make up the internal framework of red blood cells
  • Side effects of certain medicines
  • Reactions to blood transfusions

 

When to Contact a Medical Professional

 

Call your health care provider if you have:

  • Symptoms of anemia, including pale skin or fatigue, especially if these symptoms get worse
  • Urine that is red, red-brown, or brown (tea-colored)

 

What to Expect at Your Office Visit

 

Emergency treatment may be necessary. This may include a hospital stay, oxygen, blood transfusions, and other treatments.

When your condition is stable, your provider will perform a physical examination and ask about your medical history and symptoms. The physical exam may show swelling of the spleen ( splenomegaly ).

Tests that may be done include:

  • Blood chemistry panel
  • Complete blood count ( CBC )
  • Coombs test
  • Haptoglobin
  • Hemoglobin -- blood
  • Hemoglobin -- urine
  • Kidney or abdominal CT scan
  • Kidney or abdominal ultrasound

Treatment depends on the cause of hemolysis.

 

 

Open References

References

Ezenkwele UA. Emergency management of red blood cell disorders. In: Adams JG, ed. Emergency Medicine: Clinical Essentials . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 204.

Gallagher PG. Hemolytic anemias: red blood cell membrane and metabolic defects. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 161.

 

        A Closer Look

         

          Tests for Hemolytic crisis

           
             

            Review Date: 2/12/2016

            Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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