Called “hemolytic anemia” United group of blood disorders characterized by a reduction in the life cycle of red blood cells — erythrocytes. Many years in the medical community discussed the issue of the legality of the use of the term “anemia” in relation to a similar disease: the hemoglobin level in these patients is normal. However, in the classifiers of disease today is used this name.
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The types and causes of hemolytic anemia
There are hereditary and acquired hemolytic anemia.
Hereditary hemolytic anemia
The first group includes anemia caused by typically genetic abnormalities: structural abnormalities of erythrocyte membranes (membranacei), decreased activity of the important for the viability of the erythrocyte enzymes (fermentopathy), violations of the structure of hemoglobin (hemoglobinopathies).
The most common hereditary hemolytic anemia is sickle cell related to the synthesis of “wrong” in hemoglobin, giving red blood cell sickle shaped, and thalassemia, manifested in the slowdown of hemoglobin.
Acquired hemolytic anemia
Acquired anemia is associated with production of antibodies against its own red cells (autoimmune hemolytic anemia) or exposure to precipitating factors such as toxic substances, parasites that destroy red blood cells and mechanical damage of erythrocytes.
What substances can have a detrimental effect on the red blood cells, causing hemolysis? Here are some of them:
- arsine (arsenic hydrogen). Formed in the conditions of industrial production and by air enters the body;
- the phenylhydrazine. Used in pharmaceutical manufacture;
- toluylenediamine. These compounds can poison the plant for the production of dyes and a number of polymer compounds;
- cumene hydroperoxide (gitaris). Used in the manufacture of glass plastics, rubbers, acetone, phenol, epoxy and polyester resins.
Autoimmune hemolytic anemia occur when incompatibility maternal blood and fetal blood group and RH factor (hemolytic anemia of newborn) and after transfusion of the blood, disrupting the stability of the immune system to its own red blood cells, which she begins to perceive as antigens.
Symptoms of hemolytic anemia
Hemolytic anemia — a group of diseases in which reduced lifespan of erythrocytes. A characteristic feature of all of hemolytic anemia is jaundice, that is, the acquisition of skin and mucous membranes a yellowish color. Why is this happening? If hemolysis (the destruction of red blood cells) in blood ejected large amounts of bilirubin, which causes such a striking symptom. Here are other common symptoms of hemolytic anemia:
- the increase in size of liver and spleen;
- increased bilirubin in the blood;
- darkening of feces and urine (urine has a characteristic color of the color of “meat slops”);
- increased body temperature, fever;
All anemia caused by toxic chemical substances, in General, very similar. First noted headache, fatigue, nausea, possible fever. At this stage, hardly anyone gets to hospital, unless it was a mass poisoning. Further, all these symptoms increase, plus pain in the right hypochondrium and “under the spoon”, fever, the purple color of urine. 2-3 days appears jaundice, renal failure.
Very specific symptoms has thalassemia, which is a severe genetic disease: a deformed skull and bones, narrow eyes, mental and physical immaturity, the greenish hue of the skin.
Hemolytic anemia of the newborn
Hemolytic anemia of the newborn “brings” its unwitting owner of symptoms such as ascites (accumulation of fluid in the abdominal cavity), edema, high level of immature red blood cells and a sharp thin Creek.
Diagnosis of hemolytic anemia
The main in the diagnosis of hemolytic anemia is a blood picture. There is a decrease (moderate) red blood cells and hemoglobin, mikrosferocitoz (reduction of diameter, and thickening of RBCs), reticulocytosis (the appearance of immature erythrocytes), a decrease of osmotic resistance of erythrocytes, bilirubinemia. When x-ray pathways of the spinal cord (myelography) show an increase in hematopoiesis. Another important diagnostic sign is enlargement of the spleen.
Treatment of hemolytic anemia
Hemolytic anemia (especially hereditary) is effectively treated only by splenectomy — a splenectomy. Other treatments bring only temporary relief and do not protect against recurrence of the disease. Surgical intervention is recommended in the period of weakening of the disease. Complications after surgery possible (thrombosis of the portal system), but not required.
Sickle-cell anemia, thalassemia
Hemolytic anemia (sickle cell, thalassemia) use red blood cell transfusions, and blood substitutes. The patient it is important not to provoke a hemolytic crisis finding the conditions conducive to hypoxia (thin air, low oxygen).
Autoimmune hemolytic anemia treatment autoimmune anemia it is important to identify the factor leading to autoimmunity the body. Unfortunately, this rarely works, and therefore comes to the fore the use of such drugs, which inhibited the production of antibodies, and, consequently, warned of the destruction of red blood cells. It is the glucocorticoids (hydrocortisone, prednisolone, cortisone), adrenocorticotropic hormone, i.e. those substances which suppress antibody production in the spleen. And, of course, a splenectomy, which is held in the case of failure of conservative treatment. But even it does not always protect against recurrence, so surgical intervention is sometimes necessary to use hormonal agents.
Hemolytic anemia of the newborn
As for hemolytic anemia of the newborn, with the aim of prevention involves a careful tracking of the presence of antibodies in the mother. All pregnant women with a negative rhesus factor should regularly do a blood test. If antibodies are detected, then woman placed in a hospital where she was given interessny immunoglobulins.