Hemolytic anemia symptoms Hey, everyone in this class, I’m going to talk to you guys about hemolytic anemia. So I’m going to first talk to you guys about what the definition of hemolytic anemia is. And I’m also going to tell you guys some diagnostic markers that you can use to actually discern whether someone is am experiencing hemolytic anemia. And then I’m also going to tell you guys about some of the symptoms of hemolytic anemia and some of the different types of hemolytic anemia.
So to begin, what is hemaletic anemia? Well, when we look at the word hemalytic anemia, we know anemia. Many of us know anemia. So that’s the first word I’m going to actually focus on right now. So all we have to do is just break it apart.
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In a normal reference range for hemoglobin levels within the blood, it’s about 115 to 165 grams per liter. Now, this is just a sample reference range, and there are different reference ranges depending on the country you live in, which hospital you work at, et cetera. But this is the reference range I’m going to use for hemoglobin levels today. Now, there’s also a reference range for the amount of erythrocytes per liter of blood as well, which is typically 5.5 to 8.5 times ten to the 9th per liter. Now, again, this is just a sample reference range.
Read More: Heme Synthesis Pathway
The reference range does change depending on your location. Now, anemia is really either low Erythrocyte levels and or low hemoglobin levels. So according to my reference ranges, I used anemia can be due to low Erythrocyte levels. So less than the reference range, or it can be low hemoglobin levels, which is again less than the reference range that I’ve applied here. So it could be less than 115 grams per liter.
So anemia is just pretty much this what this is. It’s either low Erythrocyte levels or low hemoglobin levels. Now what is hemolytic?
When we look at hemolysis, Hemo means blood lysis is destruction. So blood destruction or degradation. So hemolysis really just means degradation of blood. So when we look at the average lifespan of a red blood cell, the average lifespan of red blood cell is actually 120 days. So hemolysis is typically considered when we see that red blood cells are not able to actually make it to 120 days of age.
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So for some reason or another, red blood cells are being destroyed before they can make it to 120 days. So when you look at the whole population of red blood cells, you can see that the average lifespan of that population of red blood cells is less than 120 days. When that is the case, we consider this hamalysis something is causing their degradation because there’s an increase in degradation. They’re not living as long as they should be. We’re going to have some adverse effects.
We’re going to have the recycling process taking a bit too long or being a little overtaxed, which means that you’re going to have some of the symptoms. I’ll show you here in a bit.
So when we look at the Erythrocyte again, it’s that concave dischaped cell has no nucleus and it has no mitochondria. Now, Erythrocytes are actually produced or a more mature form of something, what we call a reticulous site. Now, reticulous sites are more steroidal in shape. They have remnants of their nucleus, so they’re an immature version of an Erythrocyte. Now, when an Erythrocyte is broken down or destroyed, we see there’s a large release of hemoglobin.
Again, Erythrocytes are pretty much just bags of hemolobin. There are millions of hemolobin molecules within an Erythrocyte. Now, if you’ve seen my video before about heme catabolism, we know that hemoglobin is made up of heme group as well as a Globin protein. Now, the Globin protein portion of the hemoglobin is actually broken down into its respective amino acids and can be used in recycled for other processes. But the heme is a little more tricky.
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It has to be recycled in an appropriate manner. And how it is done is it’s actually eventually broken down into or processed into Billy Rubin. Now for more information, check out my heme cadablosm video. Now, the iron of heme is actually released from heme and can actually be stored as hemisitrin. Now, if there are any extra hemoglobin left that perhaps these degradation processes cannot keep up with, hemoglobin will actually be bound by something known as haptoglobin.
So Haptoglobin is a protein that will actually bind to free hemoglobin. Once the Haptoglobin binds to the hemoglobin, the Haptoglobin will actually be processed and degraded by macrophages. Now, one other thing that we don’t normally talk about when an Erythrocyte is destroyed is the fact that the Erythrocyte actually contains a lot of lactate dehydrogenate enzyme, and that is actually also released as well when Rythocytes are actually destroyed. So having looked at the schematic of how and what is processed and released from a destroyed arithmetic, we can begin to understand the diagnostic criteria or the markers we can use to look for in the diagnosis of hemolytic anemia. So the first one is, in fact bilirubin.
So we know that if there’s a lot of Erythrocytes being destroyed, we’re going to have an increase in the level of Bilirubin because bilirubin is a heme degradation product. The second thing that we’ve seen that is released from Erythrocytes is in fact lactate dehydrogenase. And because actually Erythrocytes have a large amount of lactate dehydrogenase, they actually don’t have mitochondria and rely on anaerobic metabolism. And the byproduct of anaerobic metabolism is lactate. So they use a large amount of lactate dehydrogenase.
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So you’ll see an increase in lactate dehydrogenase in the blood as well. The third thing is there’s actually a decrease in free haptoglobin. As I mentioned before, haptoglobin will actually irreversibly bind to hemoglobin, and then once it’s bound to hemoglobin, macrophages will sweep in and destroy the haploglobin. So you’ll actually see a decrease in haploglobin levels. The fourth thing that we can see is that there’s an increase in reticulocyte count.
Now I didn’t mention this before, but this is actually a normal process. If we’re seeing a decrease in Erythrocyte count, your bone marrow will actually compensate and will actually increase the production of reticulous sites to compensate for the decrease in Erythrocytes. And we call this left shifting. There’s a shift in the population of red blood cells and we’ll see more reticulocytes being released from the bone marrow into circulation to compensate for the decrease in Erythrocytes. And the last thing that we can look at that is not typically measured is actually urine hemocidin.
As I mentioned before, hemocidrin is just the storage form of iron which is released from the hemoiety. Now again, this marker is not typically looked at. We can usually figure it out from the other four markers, but this is another one. Just in case there is some issue in other markers. You can look at the urinary output of Hemo citrus.
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So now that we know some of the markers we can look at to determine if a patient is undergoing chemolkinemia, what are some of the clinical findings? What are some of the symptoms that a patient experiences when they are undergoing chemolytic anemia? Well, one of them is something known as hemoglobinuria, which is just dark urine, and that’s because there is an increased hemoglobin excretion in the urine. Another one is splent omegae. So this is because the spleen enlarges due to increased RBC filtration.
So spleen omegae may actually be the cause of hemolytic anemia. There might be an increased destruction of red blood cells due to an increased spleen. So another clinical finding we can look at is actually jaundice, and now this is because of the increased levels of bilirubin in the patient. Now one indication of jaundice is sclero ectrus, which is yellowing of the whites of the eyes. Another clinical finding could be gallstones.
Now this is because of the increased bilirubin. Again, and it’s because bilirubin is actually incorporated into bile. There might be an increase in bile formation and resulting in an increase in gallstones.
FAQs
What are the signs and symptoms of a hemolytic anemia?
I am experiencing some very light pale skin and a little bit of itching, is this a sign that I might have hemolytic anemia?
What are the signs of a potential hemolytic anemia and how can I detect that my child has it?
What are the symptoms of hemolytic anemia?
Is erythrocyte sedimentation rate a hemolytic anemia symptom?
Conclusions
If you or someone you know is experiencing any of the following symptoms, it is important to seek medical attention as soon as possible: bruising easily; fatigue; fever; shortness of breath; chest pain; lightheadedness; rapid heart rate. If left untreated, these symptoms can lead to more serious health complications such as hemolytic anemia. If you think you may be suffering from this condition, please don’t hesitate to contact your doctor for evaluation.
