Hemolytic Anemia: Symptoms, Diagnosis

What are the symptoms of hemolytic anemia?
Some people with autoimmune hemolytic anemia may have no symptoms, especially when the destruction of red blood cells is mild and develops gradually. When the destruction is more severe or rapid, most common symptoms of hemolytic anemia may include:

• abnormal paleness or lack of color of the skin
• jaundice, or yellowing of the skin, eyes, and mouth
• dark color to urine
• fever
• weakness
• dizziness
• confusion
• intolerance to physical activity
• enlargement of the spleen and liver
• increased heart rate (tachycardia)
• heart murmur

How is diagnosis of hemolytic anemia?
Hemolytic anemia is usually discovered during a medical examination through a routine blood test. In addition to a complete medical history and physical examination. A number of tests are used to diagnose hemolytic anemia. These tests can help confirm a diagnosis, look for a cause, and find out how severe the condition is.

Blood tests. The first test used to diagnose hemolytic anemia is a complete blood count (CBC). The CBC measure hemoglobin and reticulocyte count; test that reveals how many new red blood cells are being produced.

Additional blood tests. To check liver function as well as the presence of certain antibodies.

Reticulocyte count. People who have hemolytic anemia usually have high reticulocyte counts because their bone marrow is working hard to replace the destroyed red blood cells.

Peripheral smear. Some types of hemolytic anemia change the normal shape of the red blood cells.

Coombs' test. This test can show whether your body is making antibodies (proteins) to destroy red blood cells.

Haptoglobin, bilirubin test. When red blood cells break down, they release hemoglobin into the bloodstream. A low level of haptoglobin in the bloodstream is a sign of hemolytic anemia. Hemoglobin is broken down into a compound called bilirubin. High levels of bilirubin in the blood may be a sign of hemolytic anemia. High levels of this compound also occur with some liver and gallbladder diseases. As a result, you may need liver function tests to find out what's causing the high bilirubin levels.

Hemoglobin electrophoresis. This test looks at the different types of hemoglobin in your blood. It can help diagnose the type of anemia you have.

Urine test. Hemosiderin in the urine indicates chronic intravascular hemolysis. There is also urobilinogen in the urine.

Bone marrow aspiration and biopsy. These involves taking a small amount of bone marrow fluid (aspiration) and solid bone marrow tissue (a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and abnormal cells.