Classification of Hemolytic Anemia
Extrinsic (Acquired) Hemolytic Anemia
Extrinsic hemolytic anemia is an acquired condition caused by factors such as immune disorders, infections, and mechanical RBC destruction. Early diagnosis and appropriate treatment are essential.
Extrinsic (Acquired) Hemolytic Anemia
Hemolytic anemia is a condition characterized by the premature destruction of red blood cells (RBCs), leading to decreased oxygen-carrying capacity. Among its classifications, extrinsic (acquired) hemolytic anemia occurs due to external factors affecting RBC survival.
Causes of Extrinsic Hemolytic Anemia
- Autoimmune Hemolytic Anemia (AIHA): The body's immune system mistakenly attacks its own RBCs.
- Microangiopathic Hemolytic Anemia (MAHA): RBCs are mechanically disrupted in small blood vessels due to conditions like Disseminated Intravascular Coagulation (DIC) or Hemolytic Uremic Syndrome (HUS).
- Infections: Certain infections, such as malaria, destroy RBCs through direct parasitic invasion.
- Drugs and Toxins: Some medications induce hemolysis either via immune-mediated mechanisms or direct toxicity.
- Hypersplenism: An overactive spleen prematurely removes RBCs from circulation.
Symptoms
Patients with extrinsic hemolytic anemia may present with:
- Fatigue and weakness
- Pallor (pale skin)
- Jaundice (yellowing of the skin and eyes due to excess bilirubin)
- Dark urine (due to hemoglobinuria)
- Shortness of breath and tachycardia
Diagnosis
Diagnosis involves a combination of clinical assessment and laboratory investigations:
- Peripheral Blood Smear: Presence of schistocytes, spherocytes, or reticulocytosis.
- Coombs Test: Differentiates immune-mediated hemolysis.
- LDH and Haptoglobin Levels: Elevated LDH and low haptoglobin suggest hemolysis.
- Hemoglobinuria and Hemosiderinuria: Indicate intravascular hemolysis.
Treatment Options
Treatment depends on the underlying cause:
- Corticosteroids or Immunosuppressants: Used in immune-mediated hemolysis.
- Plasmapheresis: Removes harmful antibodies in severe cases.
- Blood Transfusion: Replenishes RBCs in symptomatic cases.
- Splenectomy: Considered for cases of hypersplenism.
Conclusion
Extrinsic hemolytic anemia is a diverse condition arising from various external influences on RBC survival. Early diagnosis and targeted treatment are crucial in managing this disorder effectively.
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