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Hemolytic crisis
Definition
Hemolytic crisis is the rapid destruction of large numbers of red blood cells (hemolysis). The destruction occurs much faster than the body can produce new red blood cells.
Alternative Names
Hemolysis - acute
Considerations
During a hemolytic crisis the body cannot make enough red blood cells to replace those that are destroyed.
This causes acute and often severe anemia.
The part of red blood cells that carries oxygen (hemoglobin) is released into the bloodstream, which can lead to kidney damage.
Causes
Causes of hemolysis include:
- A lack of certain proteins inside red blood cells
- Autoimmune diseases
- Certain infections
- Defects in the hemoglobin molecules inside red blood cells
- Defects of the proteins that make up the internal framework of red blood cells
- Medication side effects
- Reactions to blood transfusions
When to Contact a Medical Professional
Call your doctor or nurse if you have:
- Symptoms of anemia, including pale skin or fatigue, especially if these symptoms get worse
- Urine that is 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 or nurse will perform a physical examination and ask questions about your medical history and symptoms. The physical exam may occasionally show swelling of the spleen (splenomegaly).
Tests that may be done include:
- Blood chemistry panel
- Complete blood count (CBC)
- Coombs' test
- Kidney or abdominal CT scan
- Kidney or abdominal ultrasound
- Hemoglobin - blood
- Hemoglobin - urine
References
Schwartz RS. Autoimmune and intravascular hemolytic anemias In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 163.
Gallagher PG. Hemolytic anemias: red cell membrane and metabolic defects In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 164.
Schrier SL, Price EA. Extrinsic nonimmune hemolytic anemias. In: Hoffman R, Benz EJ, Shattil SS, et al., eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 48.
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Palm Beach Cancer Institute, West Palm Beach, FL. Review provided by VeriMed Healthcare Network. Also reviewed by Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
