From the Research
Hemolytic anemia can be classified into acute and chronic types, with acute hemolytic anemia including immune-mediated, infectious, and mechanical causes, and chronic hemolytic anemia including hereditary, autoimmune, and mechanical causes. The classification of hemolytic anemia is crucial for proper management, as treatments differ significantly between immune-mediated, hereditary, and mechanical causes of hemolysis. Some of the key types of acute hemolytic anemia include:
- Immune-mediated types like acute transfusion reactions and drug-induced hemolysis
- Infections such as malaria, babesiosis, and clostridial infections
- Mechanical causes like disseminated intravascular coagulation (DIC), thrombotic thrombocytopenic purpura (TTP), and hemolytic uremic syndrome (HUS) Chronic hemolytic anemias, on the other hand, include:
- Hereditary conditions like sickle cell disease, thalassemias, hereditary spherocytosis, G6PD deficiency, and pyruvate kinase deficiency
- Autoimmune hemolytic anemias including warm antibody (IgG-mediated) and cold antibody (IgM-mediated) types
- Mechanical hemolysis from heart valve prostheses or march hemoglobinuria
- Paroxysmal nocturnal hemoglobinuria According to a study published in 2022 1, autoimmune hemolytic anemia (AIHA) is a group of acquired autoimmune conditions resulting from the development of autologous antibodies directed against autologous red blood cell antigens, resulting in red cell lysis. Another study published in 2020 2 found that approximately one-third of AIHA patients suffered from severe anemia during hospitalization, and transfusions, even with incompatible RBCs, were safe and efficient. However, the most recent and highest quality study published in 2024 3 highlights the importance of identifying the underlying mechanism of hemolysis, as treatments differ significantly between immune-mediated, hereditary, and mechanical causes of hemolysis. In terms of treatment, corticosteroids (1-2 mg/kg/day of prednisone for autoimmune types) and immunosuppressants are commonly used, while splenectomy may be considered for certain hereditary conditions 4. Overall, identifying the underlying cause of hemolytic anemia is crucial for proper management, and treatment should be tailored to the specific cause of the disease.