Hemolytic Anemia: Treatment, Procedure, Cost and Side Effects

Haemolytic anaemia is also known as alloimmune hemolytic anemia, autoimmune hemolytic anemia (AIHA), immune hemolytic anemia, sickle cell anemia etc. Haemolytic anaemia is anemia caused due to lysis or breakdown of haem or red blood cells (RBC).

Haemolytic anaemia is a medical condition in which the red blood cells of the body are broken down, destroyed and removed from the bloodstream before their normal lifespan is over (120 days). Produced by the bone marrow, decrease in the count of these red blood cells lowers the oxygen carrying capacity from the lungs to the heart and then the entire body. Thus, anemia occurs. Haemolytic anaemia can be of two types- extrinsic and intrinsic. Extrinsic hemolytic anemia, also known as autoimmune hemolytic anemia develops when the spleen traps and destroys healthy red blood cells. Destruction of red blood cells can also occur due to other conditions like infection, tumor, medication side effects, leukaemia, etc. Intrinsic hemolytic anemia or inherited hemolytic anemia when the red blood cells produced by the body occur as defective.

Hemolytic anemia can be caused by several reasons. Because of this, each person tend to have different symptoms. The most common symptoms that many people experience when they have hemolytic anemia are jaundice, pain in the upper abdomen, leg ulcer and pain, fever, fatigue, light headedness, dizziness etc. Other less common signs and symptoms in patients with hemolytic anemia are dark urine color, heart murmur, increased heart beat rate, enlarged spleen and liver.

Definitive treatment therapy of hemolytic anemia depends on the cause and the severity of the condition. In case of marked anemia, blood transfusion can be provided. In patients with severe immune-related hemolytic anemia, steroid therapy treatment is sometimes necessary. Immunosuppressant like azathioprine, cyclophosphamide can be used when steroid therapy does not work effectively. Immunoglobulin can also be provided intravenously. In severe cases of anemia, patients might be required to remove their spleen. The spleen is where red blood cells are destroyed mostly. Removing the spleen by splenectomy surgery can reduce how fast red blood cells are destroyed.

Diagnosis and treatment of haemolytic anaemia depends on several factors like medical history, symptoms, family medical history etc. Doctors will do a physical exam to check for signs of hemolytic anemia. This includes, gently pressing on different areas of the stomach to check for tenderness, indicating enlarged spleen or liver, yellowish skin color, heart beat rhythm, check for internal bleeding etc. Diagnostic tests prescribed by the doctors are blood tests, urine tests, bone marrow tests etc. Blood tests include total blood count, bilirubin, hemoglobin, reticulocyte count, and liver function tests. A urine test is done to look for the presence of free hemoglobin and iron in it. Bone marrow tests show whether the bone marrow is healthy and making enough blood cells.

Treatment options for hemolytic anemia differ from person to person and depends on the severity of the condition, age of the patient, health, and tolerance to certain medications. There are several treatment options for haemolytic anaemia, which include, blood transfusion, intravenous immunoglobulin, corticosteroid medication, surgery. Blood transfusions are given to quickly boost the red blood cell count in the body and to replace the already destroyed red blood cells with new ones. This method of treatment is used to treat severe or life-threatening conditions of hemolytic anemia. Also, immunoglobulin can be given intravenously in the hospital to improve the overall immune system function. Medicines can also effectively improve some types of hemolytic anemia, especially autoimmune hemolytic anemia (AIHA). Corticosteroid medicines, such as prednisone, can prevent the immune system from making antibodies (proteins) against red blood cells. If patients fail to respond to corticosteroids, doctors may prescribe other kinds of medicines to suppress the immune system. Examples of such drugs are the medicines rituximab and cyclosporine. If the patient is having severe sickle cell anemia, doctors may recommend a medicine called hydroxyurea. This medicine prompts the body to produce fetal haemoglobin, the type of haemoglobin presen in new born babies. Fetal hemoglobin helps to prevent red blood cells from sickling and improves anemia in patients who have sickle cell anemia. A procedure that removes antibodies from the blood is known as plasmapheresis. This treatment may also help when other procedures do not bring effective results. Surgical operations of removing the spleen or splenectomy can also help cure anaemia. Removing the spleen from the body can stop or reduce high rates of red blood cell destruction. Blood and marrow stem cell transplants are used to treat cases of haemolytic anaemia such as thalassemia.

People with mild or acute signs and symptoms of anemia must consult a doctor for proper treatment and care. When people find the color of their skins turning yellowish and weakness takes over, they should visit a doctor for proper check up. If symptoms and diagnostic tests indicate haemolytic anaemia, patients are eligible for the treatment.

People with normal body functions, no liver or spleen enlargement, no abdominal pain or symptoms of jaundice are not eligible for the treatment. Also, when anaemia is caused due to some other problems or causes, patients do not undergo treatment for haemolytic anaemia.

There are no severe side effects associated with the treatment of haemolytic anaemia. People can get dizziness or be allergic to some types of drugs. In such cases, those can be changed. Also, blood transfusion process can be a bit risky and may cause side effects in some, not major, patients.

People with autoimmune hemolytic anemia usually respond positively to the treatment. Nevertheless, it is advised for patients to be cautioned and careful to avoid this condition. People once affected with haemolytic anaemia are advised to maintain a healthy life style in order to reduce the chances of infection. They should take the medicines and avoid food which can cause them harm. Getting plenty of rest, staying away from crowds or infection prone zones, avoiding sports not suitable are some of the things that patients need to keep in mind after treatment.

Recovering from haemolytic anaemia treatment does not take long. People can recover and get back into their normal lives after four to five weeks of treatment.

Treatment of haemolytic anaemia may cost from Rs 800- Rs 50,000. In patients with mild symptoms, taking medicines and maintaining a healthy lifestyle can cure the disease. It may also go away on its own with time. But, for acute symptoms and severe cases, where treatment procedures involve surgery or blood transfusion, the cost may go higher up. It may range from Rs 20,000- Rs. 60,000/-.

Treatment of Haemolytic anaemia is usually permanent. Patients generally respond well to the treatment procedures, particularly in case of autoimmune haemolytic anaemia. People once affected with this condition must be careful in order to avoid any further complications.