Hemolytic Anemia
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases increase red blood cell destruction.
Hemolytic anemia can be inherited or acquired:
Inherited hemolytic anemia happens when parents pass the gene for the condition on to their children.
Acquired hemolytic anemia is not something you are born with. You develop the condition later.
Symptoms
- Abnormal paleness or lack of color of the skin
- Jaundice
- Dark-colored urine
- Fever
- Weakness
- Enlarged spleen and liver
- Increased heart rate (tachycardia)
Diagnosis
- complete blood count (CBC)
- Urine test
- Bone marrow aspiration or biopsy
Treatment
- Blood transfusions
First line
- Prednisone 1 mg/kg/day
- Folic acid I mg/day
- Rituximab 1000 mg 2-14 days apart S
Second line
- Rituximab 375 mg/m2 weekly for 4 weeks or 1000 mg * 2 14 days apart
- or Splenectomy
Third line
- Azathioprine 125 mg/day
- cyclophosphamide 1 g/m2 intravenously every 28 days
- Mycophenolate 500-100 mg twice daily
- Danazol 200 mg 4 times daily
In more severe cases, the following treatments may be needed:
Surgery to remove the spleen