Describe and discuss the morphological characteristics, etiology, and epidemiology of various types of anemia
Hemolytic anemias: classification, causes, and pathophysiology
Hemolytic anemia is a condition marked by premature destruction of red blood cells. It can be classified as intrinsic or extrinsic, with various causes including genetic defects, immune reactions, and mechanical factors. Diagnosis involves blood tests, and treatment depends on the specific etiology.
Hemolytic Anemias: Classification, Causes, and Pathophysiology
Hemolytic anemia is a condition characterized by the premature destruction of red blood cells (RBCs), leading to a decreased RBC lifespan and compromised oxygen delivery to tissues.
Classification of Hemolytic Anemias
- Intrinsic Hemolytic Anemias: Caused by inherited defects in RBC membranes, enzymes, or hemoglobin (e.g., hereditary spherocytosis, G6PD deficiency, sickle cell anemia).
- Extrinsic Hemolytic Anemias: Result from external factors such as autoimmune reactions, mechanical destruction, or infections (e.g., drug-induced hemolysis, microangiopathic hemolytic anemia).
Causes of Hemolytic Anemia
Various factors contribute to the premature destruction of RBCs:
- Genetic Defects: Mutations affecting hemoglobin structure (e.g., sickle cell disease, thalassemia).
- Immune-Mediated Destruction: Autoimmune hemolytic anemia (AIHA) where antibodies target RBCs.
- Mechanical Stress: Fragmentation due to artificial heart valves or microangiopathic conditions.
- Infections & Toxins: Malaria, bacterial infections, or exposure to oxidative stress.
Pathophysiology of Hemolytic Anemia
Hemolysis leads to increased RBC breakdown, releasing hemoglobin, which is metabolized into bilirubin, potentially causing jaundice. Elevated erythropoiesis in the bone marrow compensates for RBC loss, leading to reticulocytosis.
Clinical Manifestations
- Fatigue, pallor, and dyspnea.
- Jaundice due to bilirubin accumulation.
- Splenomegaly in cases of chronic hemolysis.
Diagnosis & Management
Diagnosis involves laboratory tests such as peripheral blood smear, direct Coombs test, and serum bilirubin levels. Management depends on the underlying cause and may include corticosteroids, immunosuppressants, or splenectomy.
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