Haemolytic Anaemia
Introduction
Haemolytic anaemia results from an increase in the rate of red cell destruction in the intravascular or in the reticuloendothelial system in some pathological disorders
Classification of haemolytic anaemia
I. Acquired haemolytic anaemias
Immune
• Autoimmune (warm antibody type, cold antibody)
Alloimmune:
• Haemolytic transfusion reactions
• HD
• Allograft especially marrow transplantation
Red cell Fragmentation Syndromes:
• Arterial grafts, cardiac valve
• Microangiopathic haemolytic anaemias
Others
• March haemoglobinuria
• Infections (malaria, clostridia)
• Chemicals and physical agents
• Paroxysmal nocturnal haemoglobinulia
II. Hereditary Haemolytic Anaemia
Membrane disorders
• Hereditary spherocytosis
• Hereditary elliptocytosis
Metabolism disorders
• G6PD deficiency
• Pyruvate kinase deficiency
Haemoglobin disorders
• Abnormal haemoglobin such as Hb S, C, Unstable Hb
Risk Factors
Signs and symptoms
• Pallor jaundice
• Splenomegaly
• Anaemia
• Reticulocytosis
• Indirect hyperbilirubinemia
Other Clinical Features:
• The disease may occur at any age and sex
• Patient may present with symptom and features of Anaemia
• Symptoms are usually slow in onset however rapidly developing anaemia can occur
• Splenomegaly is common but no always observed
• Jaundice
Diagnostic criteria
Investigations
Treatment
-
Non-pharmacological
-
-
Pharmacological
- General Treatment:
i. Remove the underlying cause
ii. Blood transfusion if anaemia is severe
iii. Plasmapheresis
Note: After supportive treatment refer to higher health facility with adequate expertise and facilities
Immunosuppressant’s
• Prednisolone 1–1.5mg/kg/day (PO) for 1–3 weeks until Hb is greater than 10g/dl
AND
• Cyclosphophamide 60mg/m2 IV
OR
• Azathioprine 100–150mg/mg (PO) daily
OR
• Cyclosporin 2–5mg/
OR
• High dose immunoglobulin 400mg/kg daily IV for 5 days
• Folic acid is 5mg (PO) daily should be given to severe cases
Surgical Management
• Splenectomy may be considered in those who fail to respond
Prevention
Updated on,
14 Novemba 2020 11:08:07
References
- 1. STG