Hemolytic anemia natural history, complications and prognosis
|
Hemolytic anemia Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Hemolytic anemia natural history, complications and prognosis On the Web |
|
American Roentgen Ray Society Images of Hemolytic anemia natural history, complications and prognosis |
|
FDA on Hemolytic anemia natural history, complications and prognosis |
|
CDC on Hemolytic anemia natural history, complications and prognosis |
|
Hemolytic anemia natural history, complications and prognosis in the news |
|
Blogs on Hemolytic anemia natural history, complications and prognosis |
|
Risk calculators and risk factors for Hemolytic anemia natural history, complications and prognosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]
Overview
Natural History
The natural history depends on the etiology of the hemolytic anemia.
- Drug-induced hemolytic anemia: This tends to be transient, if the etiology is identified. Once the drug is introduced, the hemolysis typically begins within a few days. Once the offending agent is discontinued, the hemolysis begins to abate. The course is usually mild. There are typically no long-term complications from this type of hemolysis. Serologic tests, such as the direct antiglobulin test, or Coomb's test, can persist despite clinical resolution of symptoms.
- Autoimmune hemolytic anemia: This can have an unpredictable course of relapses[1] and remissions.
- Warm autoimmune hemolytic anemia in children: This has a self-limited course when treated with steroids.[1] Steroids usually result in a rapid remission, especially if a high dose or induction dose is used. Relpases are unusual. The estimated mortality rate is 10-30%.
- Hereditary etiologies of hemolytic anemia: Such etiologies include G6PD deficiency, red blood cell membrane defects, or red blood cell enzyme defects. These tend to manifest with lifelong symptoms, as these are difficult to cure. Patients with these types of hemolytic anemia have lifelong risk.
- Cold agglutinin disease: This condition results in hemolysis in the presence of cold temperatures. The hemolysis begins upon exposure to cold then abates after cold temperatures are no longer present. Post-infection cold agglutinin disease typically lasts for weeks to months then resolves. Serological tests such, as the Donath-Landsteiner antibody, can persist despite clinical resolution of the hemolytic anemia.
Complications
The complications depend on the specific type of hemolytic anemia.
- Severe anemia can cause cardiovascular collapse (failure of the heart and blood pressure, leading to death).
- Severe anemias can exacerbate heart disease, lung disease, or cerebrovascular disease.
- Severe anemia can result in transfusion dependence, in which a patient requires ongoing blood transfusions with packed red blood cells. Complications of transfusion include:
- Transfusion-associated circulatory overload (TACO)
- Transfusion-related acute lung injury (TRALI)
- Iron overload, or hemosiderosis
- Transfusion reaction due to ABO blood group incompatibility
Prognosis
The outcome depends on the type and cause of hemolytic anemia.
- Drug-induced hemolytic anemia: The prognosis of this type of anemia is typically favorable if the offending agent is discontinued.
References
- ↑ 1.0 1.1 Packman CH (2015). "The Clinical Pictures of Autoimmune Hemolytic Anemia". Transfus Med Hemother. 42 (5): 317–24. doi:10.1159/000440656. PMC 4678314. PMID 26696800.