Hemolytic anemia is characterized by premature destruction of red blood cells. There are many types of inherited and aquired hemolytic anemia. As in other anemias, the end result of hemolytic anemia is a reduction of hemoglobin, the oxygen-carrying protein inside the red blood cells. There are many causes of hemolytic anemia. In some inherited forms, red blood cells are trapped and destroyed in the spleen. In other inherited forms, there is a deficiency of the enzyme called glucose-6-phosphate dehydrogenase (G6PD) needed by red blood cells. This deficiency causes the cells to rupture and die. G6PD deficiency affects about 15% of black men in the United States. Acquired hemolytic anemia may be caused by microorganisms that infect the cells and destroy them. In some people, and autoimmune disease causes the body to mistakenly perceive its own red blood cells as foreign and kill them. Hemolytic anemia caused by an autoimmune reaction can also occur when incompatible blood is transfused into the bloodstream. Signs include pallor, fatigue, headache, shortness of breath, and rapid heartbeat. Yellowing of the skin and whites of the eyes (called jaundice) and dark urine.
Hemolytic anemia can be evaluated by inspecting a blood smear. The blood smear often reveals a large number of immature red blood cells and, in some forms of hemolytic anemia, abnormally shaped cells. Your doctor will treat the underlying condition as the first step in correcting it. For example, autoimmune disorders can be controlled by immunosuppressive drugs. People with G6PD deficiency should alert their doctor so that they are not prescribed medicines that could cause red blood cells destruction. Some inherited forms of hemolytic anemia are treated by surgical removal of the spleen, where the red blood cells are being destroyed.