Hemolytic anemia is a condition that in scientific terms, is the premature destruction of the red blood cells, leading to the deficit of these red cells in the body. It may manifest with several symptoms ranging from mild including fatigue and pallor to more severe complications such as jaundice and an enlarged spleen. Proper diagnosis is essential to determine the underlying cause and guide appropriate treatment. In this blog, we’ll explore the essential blood tests and procedures used to diagnose hemolytic anemia, with a focus on identifying autoimmune hemolytic anemia and other causes of hemolysis.
What Is Hemolytic Anemia?
It is observed when the body destroys the red blood cells at a rate higher than it can produce them. RBCs usually have a life of approximately 120 days. In this disease, they are destroyed early, hence there is an imbalance in the oxygen-carrying capacity and many other systemic symptoms. Hemolytic anemia can be divided into two major types:
- Intrinsic Hemolytic Anemia: This is a result of intrinsic reasons due to flaws that may exist in red blood cells themselves and which might have been a result of inherited conditions for example; sickle cell anemia, and thalassemia.
- Extrinsic Hemolytic Anemia: On the other hand it results from extrinsic reasons that may come up from such factors such as autoimmune diseases, infection drugs, and toxins leading to the destruction of RBC.
- One of the leading exogenous causes of this disease is AIHA, which results from an inappropriate immune mechanism due to sticking and damaging the red blood cells.
Characteristics of Hemolytic Anemia
The following are manifestations observed during the hemolytic anemia stage, among them
- Yellowish color skin-jaundice
- Breath difficulties
- Rapid heart rate
- Colorful urine
- Hepatosplenomegaly
These symptoms will then be combined with lab test diagnosis as well as with specific blood tests and other test diagnostic tests and tools.
Major Blood Tests for Final Diagnosis of Hemolytic Anemia
Complete Blood Count, or CBC
The CBC test is sometimes taken as the first line of an investigation when hemolytic anemia is suspected. CBC would provide general information concerning the blood counts, i.e., RBC count, the level of hemoglobin, hematocrit, as well as reticulocyte count. Patients characterized in the case of hemolytic anemia tend to be:
Hb level and RBC number lowered.
The reticulocyte count is elevated because the bone marrow attempts to compensate for the destruction of RBCs by producing more immature red blood cells.
Peripheral Blood Smear:
This test checks the morphology of a blood sample in a microscope for shapes, sizes, or any other characteristic of red blood cells that are abnormal. Some of the most common findings in hemolytic anemia include the following
Spherocytes, or small, round RBCs; they characteristically occur in autoimmune hemolytic anemia.
Sheminated RBCs (schistocytes), which indicates mechanical red blood cell destruction like in TTP or DIC
Direct Coombs Test is also known as Direct Antiglobulin Test:
This Direct Coombs test is necessary to verify the diagnosis of immune hemolytic anemia. It will detect the presence of antibodies or complement proteins attached to the RBC membranes. This is an indirect indicator that the immune system is attacking RBCs. A positive reaction gives a good impression that this person suffers from AIHA.
Levels of Lactate Dehydrogenase
LDH is an enzyme leaking into the blood with a lysis of RBCs. Markedly raised levels of LDH are a good indicator for hemolysis and hence prove helpful in the diagnosis of conditions like hemolytic anemia.
Haptoglobin Level:
Haptoglobin binds to free hemoglobin released from lysed red blood cells (RBCs). In hemolytic anemia, haptoglobin levels decrease as it binds to free hemoglobin, forming complexes that lead to its consumption.
Bilirubin Level:
Red blood cell breakdown increases bilirubin levels in the blood, often leading to jaundice due to excessive bilirubin concentration.
The measured amounts of the substance found determine the rate of the process.
Measuring Methods of Determination for Cause
Bone Marrow Aspiration and Biopsy:
A bone marrow biopsy should be performed if the diagnosis of hemolytic anemia cannot be explained by one. The place would otherwise be a usual place a sample of the bone marrow may be taken for check-up about its ability or inability to produce red blood cells. It can also serve and differentiate other diseases such as leukemias, aplastic anemias, or myelodysplastic syndromes.
Flow cytometry
It has been in use for decades in diagnosing a very rare condition known as hemolytic anemia. The condition arises from the damage that happens to the blood cells when there is a deficiency of some surface protein which is termed paroxysmal nocturnal hemoglobinuria.
The genetic test is in use to diagnose whenever it is hereditary, as in sickle cell anemia or thalassemia. This is prescribed with family counseling and other treatment.
Hemolysis Causes:
Causes of hemolysis also require proper diagnosis and then proper treatment. Causes are broadly classified into the following types;
- Autoimmune Disorders: Causes like lupus and rheumatoid arthritis cause AIHA. This means that the immune system is reacting against RBCs
- Infections: Infection, in malaria and sepsis, leads to RBCs destruction
- Medications and Toxins: Drugs, primarily penicillin and quinine, and toxins, in some snake bites or chemical toxicants, induce hemolysis.
- Mechanical Cause : The clots of blood, burns as such extreme conditions will ruin the RBC. This will cause hemorrhaging ultimately.
Conclusion
Diagnosing hemolytic anemia requires quite several blood tests and other diagnostic procedures. Once a kind of hemolysis and its cause are established, particular treatment may be directed to its underlying problems, such as an autoimmune condition or a genetic disorder. Because exact and timely diagnosis is indispensable for the prevention of complications and therefore for successful treatment, these tests are necessary tools in the practice of modern medicine.
