The hemolytic anemias

The hemolytic anemias are characterized by excessive blood destruction which results in such symptoms as jaundice, formation of gallstones, and increased amounts of urobilinogen and urobilin in the stools and urine. Phagocytosis of red blood cells undergoing destruction with deposition of hemo­siderin results in splenomegaly. The acute forms may result from bloodstream infec­tions or various types of hemolytic poisons. The chronic forms are often congenital dis­orders and include familial hemolytic icterus, Mediterranean anemia and sickle cell anemia.Acute Hemolytic Anemia. Acute hemolytic anemia may result from mismatched transfusions, hemolytic toxins, such as snake venoms, bacterial toxins, phenyl hydrazine or phenol, and from malaria or bartonellosis. The symptoms include chills and rigor, vomiting and diarrhea, pain in the back and legs, hemoglobinuria, albuminuria and anuria. The red blood cells show marked variation in size and staining re­action. There is striking evidence of regen­eration, including reticulocytosis and cir­culating normoblasts. Treatment consists of removal of the cause.