Etiology, Pathogenesis, Hematologic Indices, and Peripheral Blood Characteristics of Acquired Hemolytic Anemia

Introduction

Acquired hemolytic anemia (AHA) refers to a group of disorders characterized by the premature destruction of red blood cells due to external factors. These factors include immune system dysfunction, infections, toxins, and mechanical injury.

Pathogenesis and Mechanisms Leading to Hemolysis

Immune-Mediated Hemolysis

Autoimmune hemolytic anemia (AIHA) occurs when autoantibodies target red blood cells, leading to their destruction. This process involves complement activation and phagocytosis in the spleen.

Mechanical Hemolysis

Hemolysis can result from mechanical trauma, such as microangiopathic hemolytic anemia (MAHA), where red blood cells are fragmented due to passage through fibrin strands in damaged vessels.

Chemical and Infectious Causes

Toxins, medications, and infections can induce hemolysis by interfering with the red cell membrane or enzyme function.

Hematologic Indices and Peripheral Blood Characteristics

Patients with AHA often present with elevated reticulocyte counts, decreased haptoglobin levels, and increased lactate dehydrogenase (LDH). Peripheral blood smears may show spherocytes, schistocytes, and polychromasia.

Diagnosis and Management

Diagnosis includes direct antiglobulin tests, peripheral smear analysis, and biochemical markers. Treatment depends on the underlying cause and may involve corticosteroids, immunosuppressants, plasma exchange, and supportive therapy.

Conclusion

Understanding the pathogenesis and mechanisms leading to hemolysis in acquired hemolytic anemia aids in precise diagnosis and targeted therapy, improving patient outcomes.