Causes and risk factors
Early destruction of the RBC before the stipulated life span can be caused due to a variety of causes; a few are inherited while others are acquired. In inherited hemolytic anemia, due to certain defect in the genes, abnormal red blood cells are produced. These blood cells can either have some defect in the intrinsic membrane or can have abnormal hemoglobin or there can persist some defect in the enzymes which are responsible for maintaining the red blood cells in a healthy state. These abnormalities make the cells fragile, as a result of which they undergo easy lysis. On the other hand, there can occur a healthy production of red blood cells, but due to certain systemic diseases or visceral diseases these RBCs are destroyed. A few causes under this category are infections, diseases of the spleen, blood cancers, reaction to certain medications, and immune disorders, etc.
Clinical presentation
The symptoms can range from mild to severe ones. Those with minimal changes in RBC can remain asymptomatic for long while others can present with complaints of fatigue and tiredness. Due to inadequate number of blood cells, the circulation is also hampered. As a result, the skin becomes pale; the extremities are cold to touch. Difficulty in breathing, pain in chest, pain in abdomen, etc., are other symptoms seen. Due to lack of blood supply, the heart has to overwork. Simultaneously, the other parts of the body are deprived of adequate amount of oxygen which in turn gives rises to a variety of complaints. In severe cases, yellowish discoloration of the skin and mucous membrane, fever, chills, prostration, and even shock can be seen. The urine becomes dark red colored due to the presence of free hemoglobin in the blood.
Investigations and diagnosis
Taking into consideration the complaints mentioned by the patient, a physical examination of the patient is carried out. Accordingly, certain sets of investigations are advised. A complete blood test along with some specialized blood tests helps in confirming the diagnosis. Peripheral smear, reticulocyte count, Coombs test, etc., are done. Along with this urine test, bone marrow, liver function test, and other tests, if needed, can also be done.
Treatment
The treatment aims at treating the underlying cause so that the destruction of the cells is stopped and new healthy blood cells are formed. The treatment comprises of administration of medications like corticosteroid medications or immune suppressing medications. Blood transfusion can be done. In cases where this does not work, plasmapheresis may be helpful. In case where the spleen is diseased, surgical removal of the spleen is needed. In very severe cases, bone marrow transplantation may be required.
Other modes of treatment:
Certain other modes of treatment can also be helpful in coping up the disease. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints.
