Red blood cells develop in the bone marrow, which is the sponge-like tissue inside your bones. Your body normally destroys old or faulty red blood cells in the spleen or other parts of your body through a process called hemolysis. Hemolytic anemia occurs when you have a low number of red blood cells due to too much hemolysis in the body.
There are many types of hemolytic anemia, which doctors diagnose based on the underlying cause of your anemia. Certain conditions can cause hemolysis to happen too fast or too often. Conditions that may lead to hemolytic anemia include inherited blood disorders such as sickle cell disease or thalassemia, autoimmune disorders, bone marrow failure, or infections. Some medicines or side effects to blood transfusions may cause hemolytic anemia.
Hemolytic anemia can develop suddenly or slowly, and it can be mild or severe. Signs and symptoms may include fatigue, dizziness, heart palpitations, pale skin, headache, confusion, jaundice, and a spleen or liver that is larger than normal. Severe hemolytic anemia can cause chills, fever, pain in the back and abdomen, or shock. Severe hemolytic anemia that is not treated or controlled can lead to serious complications, such as irregular heart rhythms called arrhythmias; cardiomyopathy, in which the heart grows larger than normal; or heart failure.
To diagnose hemolytic anemia, your doctor will do a physical exam and order blood tests. Additional tests may include a urine test, a bone marrow test, or genetic tests. People who are diagnosed with mild hemolytic anemia may not need treatment at all. For others, hemolytic anemia can often be treated or controlled. Treatments may include lifestyle changes, medicines, blood transfusions, blood and bone marrow transplants, or surgery to remove the spleen. If your hemolytic anemia is caused by medicines or another health condition, your doctor may change your treatment to control or stop the hemolytic anemia.