Hemolytic anemia in emergency and intensive care medicine

Hemolytic anemia (HA) is caused by premature destruction or degradation of red blood cells (RBC). Low hemoglobin, suppressed haptoglobin, reticulocytosis as well as an elevation of lactate dehydrogenase and bilirubin are common laboratory findings in HA. Intracorpuscular HA due to defects of the RBC themselves are distinguished from extracorpuscular HA due to external factors. Severity of symptoms such as fatigue and dyspnea depend on the degree of anemia. For optimal treatment of HA, a detailed evaluation of the patient history (including hereditary RBC defects, B symptoms and travel history) is necessary. Additional diagnostics (hematological diagnostics, infectious disease diagnostics, immunological diagnostics, computed tomography [CT] scan) should be performed according to the patient's individual requirements. Treatment of HA depends on the etiology. If HA is immune-mediated, immunosuppressive therapy is indicated, whereas HA due to infections usually improves after adequate anti-infective therapy. Anti-infective therapy should also be considered in patients with sickle cell disease who present with severe HA. In general, HA can be treated effectively in most cases.