Types of Hemolytic Anemia

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  • 0:03 Hemolytic Anemia
  • 1:17 Inherited Hemolytic Anemia
  • 3:50 Acquired Hemolytic Anemia
  • 5:45 Lesson Summary
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Instructor: Rebecca Gillaspy

Dr. Gillaspy has taught health science at University of Phoenix and Ashford University and has a degree from Palmer College of Chiropractic.

Hemolytic anemia is anemia that results from the destruction of red blood cells. It can be inherited or acquired. Learn about hereditary conditions that cause hemolytic anemia as well as the types of acquired hemolytic anemias.

Hemolytic Anemia

We all know people who have lived long lives, some well into their 90s and beyond. Yet, very few of the cells found within the human body live that long.

In fact, all body cells, with the exception of some nerve cells, will die and be replaced throughout a person's lifetime. For example, the typical red blood cell in a healthy individual has a lifespan of about 120 days.

Red blood cells are made in the bone marrow, which is the soft, spongy tissue found inside bones, and then circulate through your bloodstream until they die. When the blood cells in a healthy individual die, the bone marrow replaces them with new cells.

However, this process can be more complicated in a person with hemolytic anemia. Hemolytic anemia is a condition in which the red blood cells are destroyed faster than they can be replaced. With hemolytic anemia, the bone marrow has trouble keeping pace with the body's need for blood cells due to the premature destruction of red blood cells, which is called hemolysis. This term is easy to recall if you remember that the prefix 'hemo' refers to blood and the suffix 'lysis' refers to destruction.

Inherited Hemolytic Anemia

Hemolytic anemias are classified as either inherited or acquired. Inherited hemolytic anemia is when red blood cells are prematurely destroyed due to defects passed through genes from parent to child.

With this condition, the gene in charge of red blood cell production has a defect resulting in abnormal cells that get targeted for early destruction. It is as if these cells are born with a bull's-eye on their backs.

There are many types of inherited hemolytic anemias and some are due to a problem with the oxygen-carrying protein of the cell, which we know as hemoglobin. If there is a problem with the hemoglobin, the red blood cell loses its oxygen-carrying ability and therefore its value to the body, so the body paints a bull's-eye on that cell and destroys it.

This is the case with both sickle cell anemia, where the red blood cells are sickle-shaped due to an abnormality in their hemoglobin, as well as with thalassemia, where there is an abnormal production of hemoglobin.

Inherited hemolytic anemia can also be due to an issue involving the red blood cell membranes, as we see in hereditary spherocytosis, where the cell membrane is sphere-shaped, as opposed to the normal biconcave or 'donut-shape' we are used to seeing. Notice the word 'spher' (like 'sphere') appears in the term, and this will help you to remember this condition. Any time a cell is not its normal shape, it gets targeted for premature destruction, much like a factory worker would remove a defective widget coming down the conveyor belt.

Inherited anemias may also be due to problems with the red blood cell metabolism, as is the case with G6PD deficiency. G6PD stands for glucose-6-phosphate dehydrogenase. We see the letters 'ase' at the end of this long word, so we know that this substance is an enzyme, because 'ase' is a common suffix used to name enzymes. So, G6PD deficiency is an anemia that is caused by an insufficient enzyme. G6PD protects your red blood cells from exposure to certain drugs or other toxins or stressors. Without the enzyme, the red blood cells are destroyed when they come in contact with these types of substances, as if they are soldiers out of ammunition that get ambushed by the enemy.

Acquired Hemolytic Anemias

As we mentioned, hemolytic anemias can also be classified as acquired hemolytic anemias. With acquired hemolytic anemias, your red blood cells develop normally, but the red blood cells are prematurely destroyed by factors acting on them as they circulate.

The different types of acquired hemolytic anemias are based on what caused the condition. This might be an adverse response to a drug, such as in the case of drug-induced hemolytic anemia, where certain medications bind to the surface of the red blood cell, causing antibodies to develop. The cell is then targeted for destruction in the spleen. This can happen with some chemotherapy medications but can also be associated with more common drugs, such as penicillin or acetaminophen, which you might know as Tylenol.

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