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Hemolytic crisis

Definition

Hemolytic crisis occurs from the rapid destruction of large numbers of red blood cells (hemolysis). The destruction occurs much faster than the body can compensate by producing more red blood cells.

Alternative Names

Hemolysis - acute

Considerations

A hemolytic crisis causes acute (and often severe) anemia, because the body cannot make enough red blood cells to replace those destroyed. The part of red blood cells that carries oxygen (hemoglobin) is released into the circulation, which can lead to kidney damage.

Causes

There are many causes of hemolysis, including:

A lack of certain enzymes in red blood cells
Autoimmune disease
Certain infections
Changes to the hemogloben molecules inside red blood cells
Defects of the proteins that make up the internal framework of red blood cells
Medication side effects
Reactions to transfusions

Many of these conditions can lead to a hemolytic crisis.

When to Contact a Medical Professional

If you have any of the following symptoms, contact your doctor:

A decrease in the amount of urine you produce
Fatigue, pale skin, or other symptoms of anemia, especially if these symptoms get worse
Urine that looks red, red-brown, or brown (tea-colored)

What to Expect at Your Office Visit

Emergency treatment may be necessary. This may include a hospital stay, oxygen, blood transfusions, and other treatments.

When your condition is stable, your doctor will perform a physical examination and ask questions, such as:

When did you first notice symptoms?
What symptoms did you notice?
Do you have a history of hemolytic anemia, G6PD deficiency, or a kidney disorder?

The physical examination may occasionally show swelling of the spleen (splenomegaly).

Tests may include:

Blood chemistry panel
Complete blood count (CBC)
Coombs' test
Kidney or abdominal CT scan
Kidney or abdominal ultrasound
Serum free hemoglobin
Urine free hemoglobin

References

Schwartz RS. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 164.

Golan DE. Hemolytic anemias: red cell membranes and metabolic defects. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 165.

Review Date: 11/23/2008
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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