Acquired Hemolytic Anemia Symptoms Treatment &Diagnosis | Prevention

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Acquired Hemolytic Anemia  Symptoms

The symptoms acquired in hemolytic anemia are mild. If the problem develops slowly, symptoms that may occur first include:

  • Feeling weak or tired more often than usual, or with exercise.
  •  Headaches.
  •  Problems concentrating or thinking.

If the anemia gets worse, symptoms may include:

  • Lightheadedness when you stand up.
  •  Pale skin colour (pallor).
  •  Shortness of breath.
  •  Sore tongue.

Causes of Acquired Hemolytic Anemia 

  •  Certain chemicals, drugs and toxins.
  •  Infections.
  •  Transfusion of blood from a donor with a blood type that does not match.
  •  Certain cancers.
  •  When antibodies form against red blood cells for no reason, the condition is called idiopathic autoimmune hemolytic anemia.
  •  Complication of another disease.
  •  Past blood transfusions.
  • Pregnancy (if the baby’s blood type is different from the mother’s).

Diagnosis Of Acquired Hemolytic Anemia

  •  Absolute reticulocyte count.
  •  Direct or indirect Coombs test.
  •  Hemoglobin in the urine.
  • LDH (level of this enzyme rises as an result of tissue damage).
  •  Red blood cell count (RBC), hemoglobin, and hematocrit.
  •  Serum bilirubin level.
  • Serum free hemoglobin.
  •  Serum haptoglobin.
  •  Donath-Landsteiner test.
  •  Cold agglutinins.
  •  Free hemoglobin in the serum or urine.
  •  Hemosiderin in the urine.
  •  Platelet count.
  •  Protein electrophoresis – serum.
  • Pyruvate kinase.
  • Serum haptoglobin level.
  •  Urine and fecal urobilinogen.

Treatment for Acquired Hemolytic Anemia 

The first treatment tried is most often a steroid medicine, such as prednisone. If steroid medicines do not improve the condition, treatment with intravenous immunoglobulin (IVIG) or removal of the spleen (splenectomy) may be considered. If the immune system do not respond to steroids. Drugs such as azathioprine (Imuran), cyclophosphamide (Cytoxan), and rituximab (Rituxan) have been used. Blood transfusions are given with caution, because the blood may not be compatible and it may cause more red blood cell destruction.

Prevention Acquired Hemolytic Anemia

Screening for antibodies in donated blood and in the recipient may prevent hemolytic anemia related to blood transfusions

Type of acquired hemolytic anemia TreatmentMechanism
Warm autoimmune
hemolytic anemia
Corticosteroid therapy, initiated
with the blood transfusion.
Suppress the immune
destruction of the transfused
red cells.
High-dose intravenous
γ-globulin (IVIgG)
This therapy causes blockage of
the reticuloendothelial system
and reduces the clearance of the
IgG-sensitized red blood cells.
Splenectomy.Splenectomy removes the major
site of antigen presentation and,
in turn, reduces antibody
Vincaalkaloids, azathioprine and
Suppress immune system
Danazol. The possible mechanisms
include: reduction in red cell
bound C3d; immunomodulation
by alteration of T-cell subsets;
and reduction of FcR in the
reticuloendothelial (RE) system.
Cold autoimmune
hemolytic anemia
Plasmapheresis that is
transfusion blood in warm
To reduce the level of IgM cold
Alkylating agents. May reduce the production of
cold autoantibody.
hemolytic anemia
Rh-negative pregnant woman
should receive passive
immunization with Rh immune
globulin at 28-weeks’ gestation.
Neutralize antibodies in womb.
hemolytic anemia
Stop drug therapy
hemolytic anemia
Immunosuppressive therapy using corticosteroids, antilymphocyte
globulin or cyclosporin A has been used.


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