Hemolysis refers to the destruction of red blood cells (RBCs). Typically, RBCs can live for up to 120 days before the body naturally destroys them. However, certain conditions and medications may cause them to break down quicker than usual. Show RBCs, or erythrocytes, are one of the main components of blood. They have the shape of a slightly indented, flattened disk and help transport oxygen to and from the lungs. The average life span of a healthy RBC is roughly 4 months. Typically, the body will destroy old or damaged RBCs in the spleen or in other parts of the body through a process known as hemolysis. Usually, the body is capable of quickly replacing RBCs, producing around 2 million blood cells every second. However, people may experience symptoms of anemia if the body has a low number of RBCs due to excessive hemolysis. In this article, we discuss hemolysis in detail, including its potential causes and treatment options. Hemolysis is the breakdown of RBCs. Some people may also refer to hemolysis by other names, such as hematolysis, erythrolysis, or erythrocytolysis. Hemolysis is a natural bodily process that occurs when RBCs become too old. As RBCs age, they begin to lose certain properties and work less efficiently. For example, they may lose their deformability, which allows them to reversibly change shape to pass through blood vessels. As RBCs begin to lose functionality, they accumulate signals that initiate erythrocyte turnover. The body typically performs hemolysis in the spleen. As blood filters through this organ, it is able to detect any old or damaged RBCs. Then, large white blood cells, or macrophages, break down these RBCs. However, some conditions, medications, and toxins may cause RBCs to break down quicker than usual. A doctor may measure a person’s hematocrit levels. This refers to the percentage of RBCs in the body. A typical hematocrit level can vary depending on many factors, such as age and race. However, low levels may suggest a high turnover of RBCs. There are many potential factors that may lead to hemolysis. The cause of hemolysis can be extrinsic, coming from an outside source, or intrinsic, which is when it comes from the RBC itself. ExtrinsicExtrinsic causes include certain conditions or outside factors that destroy RBC, such as:
IntrinsicCertain conditions may result in changes within the RBC itself, which can lead to hemolysis. This can include deformities in the cell structure and metabolism or in the hemoglobin structure. These conditions may include:
Hemolytic disease of the newborn, which health experts also call erythroblastosis fetalis, is a blood condition in which a rhesus (Rh) factor incompatibility occurs during pregnancy. This refers to a protein that may be present on the surface of RBCs. If a person with Rh-negative blood becomes pregnant, and the fetus inherits Rh-positive blood from the person’s partner, it can result in a harmful immune response. Around 1–3 in 1,000 people experience this reaction. During pregnancy, blood from the fetus can cross the placenta and enter the parent’s blood. With Rh incompatibility, the parent’s immune systemmay recognize this blood as foreign material and produce antibodies against the Rh-positive blood. This is more likely to occur after the first pregnancy, since the pregnant person’s immune system will recognize the fetus’s blood as foreign and have antibodies ready. If doctors detect this early, they can prevent this condition by giving the parent an Rh immunoglobulin (RHIg) to prevent their immune system from producing antibodies. A person will receive RHIg as an injection at 28 weeks of pregnancy to prevent the production of antibodies, and within 72 hours of delivering the baby with Rh-positive blood to prevent the production of antibodies that could affect a future pregnancy. AIHA is a rare condition in children, affecting 0.8 in 100,000 children under the age of 18 years. It can occur after a recent viral infection or after using certain drugs. It can also be due to some conditions. The most common form of AIHA in children is due to warm-reactive antibodies. The term “warm-reactive” refers to the fact that optimal antigen binding occurs close to body temperature at 98.6ºF. A 2021 study notes that a sudden presentation of AIHA is often life threatening and progresses quickly, requiring prompt diagnosis, treatment, and monitoring. Initially, a doctor will review a person’s symptoms and medical history and perform a physical examination. If they suspect hemolytic anemia, they may request the following tests:
Treatment options will depend on the cause of hemolysis. Moreover, doctors will consider the following when creating a treatment plan:
Treatments may include:
Hemolysis is a natural process where the body destroys older RBCs that no longer work efficiently. However, some conditions, medications, and toxins may cause RBCs to break down prematurely. When this occurs, people may experience symptoms of anemia, such as fatigue, dizziness, and headaches. In other cases, symptoms can be more severe. A person exhibiting early signs of anemia should consult a doctor for a prompt diagnosis and treatment. What does blood hemolysis mean?Hemolysis is the breakdown of red blood cells, which can have an effect on laboratory results. Serum samples containing more than 100 mg/dL of hemoglobin can cause non-specific binding in serologic tests. Therefore, serologic testing is not recommended for a serum sample containing more than this amount of hemoglobin.
What happens to blood when hemolysis occurs?Hemolytic anemia is a disorder in which red blood cells are destroyed faster than they can be made. The destruction of red blood cells is called hemolysis. Red blood cells carry oxygen to all parts of your body. If you have a lower than normal amount of red blood cells, you have anemia.
Can you survive hemolysis?People who have mild hemolytic anemia may not need treatment, as long as the condition doesn't worsen. People who have severe hemolytic anemia usually need ongoing treatment. Severe hemolytic anemia can be fatal if it's not properly treated.
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