Hemolytic Anemia in an Internal Medicine Service: Population Characterization

Abstract

Background: Hemolytic anemia represents 5% of all anemias
and is characterized by a reduction in the survival time of
Red Blood Cells (RBC). The destruction of RBC may result
from intravascular or extravascular hemolytic phenomena.
The last one is most often associated with autoimmune phenomena, chemical/drug toxicity, infections, hypersplenism
and mechanical destruction.
The objective of the study was to describe the demographic
characteristics, main causes and clinical characteristics of
patients with extrinsic hemolytic anemia.
Methods: A retrospective study between January 2010 and
December 2014 of patients with HA who were hospitalized in
an Internal Medicine Service of a Central Hospital. Hemolytic
markers were evaluated.
Results: A total of 22 patients with a mean age of 67.6 (±
17.9 years) were included; 54,5% were male. About 81.8%
had a positive direct antiglobulin test and the rest a negative
one. Between patients with auto-immune hemolytic anemia,
61.1% were associated with infections. At the time of diagnosis, the average value of Hb was 7.5 g/dL, requiring on
average, 9.8 days reaching values above 9 g/dL. For the
treatment, 36.4% of patients did corticotherapy, 22.7% corticotherapy in association with transfusion of red blood cells
and 13.6% only transfusion, beyond the treatment of the underlying cause. The mortality rate was 9%.
Conclusion: Hemolytic anemia. can result from many causes
and the majority result from infectious processes. The identification of the underlying cause of hemolysis is extremely important for the diagnostic and therapeutic approach. There is
a low mortality rate and the prognosis depends on the underlying cause but the risk increases in elderly patients.