Hemolytic crisis

Hemolytic crisis is the rapid destruction of large numbers of red blood cells (hemolysis). The destruction occurs much faster than the body can produce new red blood cells.

Considerations

During a hemolytic crisis, the body cannot make enough red blood cells to replace those that are destroyed. This causes acute and often severe anemia.

The part of red blood cells that carries oxygen (hemoglobin) is released into the bloodstream. This can lead to kidney damage.

Causes of Hemolytic crisis

Causes of hemolysis include:

  • A lack of certain proteins inside red blood cells
  • Autoimmune diseases
  • Certain infections
  • Defects in the hemoglobin molecules inside red blood cells
  • Defects of the proteins that make up the internal framework of red blood cells
  • Medication side effects
  • Reactions to blood transfusions

When to Contact a Health Professional

Call your doctor or nurse if you have:

  • Symptoms of anemia, including pale skin or fatigue, especially if these symptoms get worse
  • Urine that is red, red-brown, or brown (tea-colored)

What to Expect at Your Office Visit

Emergency treatment may be necessary. This may include a hospital stay, oxygen, blood transfusions, and other treatments.

When your condition is stable, your doctor or nurse will perform a physical examination and ask about your medical history and symptoms. The physical exam may occasionally show swelling of the spleen (splenomegaly).

Tests that may be done include:

References

Schwartz RS. Autoimmune and intravascular hemolytic anemias In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 163.

Gallagher PG. Hemolytic anemias: red cell membrane and metabolic defects In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 164.

Review Date: 2/24/2014
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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