• Hemolytic Anemia Overview

    Hemolytic anemia is a condition in which red blood cells, which carry oxygen from the lungs to all parts of the body, are destroyed faster than usual and the bone marrow works harder to make them. 

    There are two types of hemolytic anemia. Intrinsic hemolytic anemias, due to a defect in the red blood cells themselves which includes problems with the red blood cell itself (e.g. thalassemia, sickle cell anemia, hereditary sperocytosis), are usually inherited. With these conditions, red blood cells are destroyed earlier than normal. Extrinsic hemolytic anemias are caused factors outside the red blood cell that damage (e.g. antibodies from an autoimmune disorder, burns, medications) and are usually acquired. In these conditions, red blood cells are usually healthy when they are produced  by the bone marrow, but later they are destroyed directly in the bloodstream or get prematurely trapped and recycled in the spleen.

    Hemolytic Anemia Treatment at Dana-Farber/Boston Children's

    Patients with hemolytic anemia are treated at Dana-Farber/Boston Children's Cancer and Blood Disorders Center through the Blood Disorders Center. Continue reading to learn more about hemolytic anemia or visit the Blood Disorders Center homepage to learn about our expertise and treatment options for this condition.

    Symptoms & Diagnosis

    Common symptoms of hemolytic anemia include:

    • Pale skin, lips and hands
    • Paleness under the eyelids
    • Yellow color of the skin (jaundice) 
    • Yellow color of the eyes (scleral icterus)
    • Dark color to urine
    • Weakness
    • Dizziness
    • Confusion
    • Difficulty with physical activity
    • Increased heart rate
    • Enlarged spleen or liver
    • Heart murmur

    A doctor may suspect hemolytic anemia based on general findings from a complete physical exam and common complaints, such as tiring easily, pale skin and lips, and a fast heartbeat. The condition is usually discovered through a medical exam and with blood and urine tests.

    The diagnosis may be confirmed with a bone marrow exam in which samples of the fluid (aspiration) and solid (biopsy) portions of the bone marrow are withdrawn with a needle under local anesthesia. After all tests are completed, doctors will be able to outline the best treatment options.

    Treatment & Care Options

    Treatments for hemolytic anemia vary depending on the type and cause of the disease and may include: 

    • Steroid therapy or intravenous immune globulin to decrease the immune system attack on the red blood cells
    • Red blood cell transfusion, may be used when anemia is severe or therapy is ineffective

    If a child has severe hemolytic anemia, hospitalization may be needed for the following:

    • Exchange transfusion to replace damaged blood with fresh blood
    • Surgery to remove the spleen (usually reserved for children who don’t respond to other therapies)

    Long-term Outlook

    The outlook for hemolytic anemia depends on the type and cause of the disease. The overall mortality rate is low.
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