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Halle’s Fight Like a Girl Story (Systemic Lupus Erythematosus, Hemolytic Anemia)

Like many, my story begins with a series of symptoms that could be linked to a handful of average ailments: fatigue, body aches, swelling, and the occasional purple hands and feet. At 12 years old, your first instinct isn’t that you may be suffering from what would become a lifelong battle for your health, but rather just a passing “bug” that could easily be fixed with a simple antibiotic.

It was the beginning of my 7th grade year, and being the social butterfly that I was, it was chalked up by family doctor as a severe case of mono. Although I had tested negative several times, my whole field hockey team was dropping like flies, so I was treated accordingly. And in a week’s time,…

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  MAHA, TTP, HUS, DIC... Oh My! Understanding Microangiopathic Hemolytic Anemias

This blog post is going to focus on microangiopathic hemolytic anemias (MAHA) – namely, three major conditions characterized by microangiopathic hemolytic anemia: Thrombotic Thrombocytopenic Purpura (TTP), Hemolytic Uremic Syndrome (HUS), and Disseminated Intravascular Coagulation (DIC). These conditions should be added to the “Can’t Miss List” for Emergency Physicians.

 “Cannot Miss” Acute Hemolytic Diseases in the ED

Hemolytic anemias are rare and many present with gradual onset of symptoms. However, some can cause rapid hemolysis and contribute to high morbidity and mortality

Articles of Interest

Autoimmune Hemolytic Anemia

•Autoimmune Hemolytic Anemia can occur in individuals of all ages (children and adults) •Women are more likely to be affected by this condition than men •All racial and ethnic groups are affected

EM@3AM: Acute Hemolytic Anemia

Red blood cell destruction termed “Hemolysis” can occur in the extravascular space (as part of the spleen, liver, or lymph nodes) or intravascular space (within vessels). Extrinsic Hemolytic Anemia: hemolysis due to factors outside the RBC. Examples: Autoimmune hemolytic (AIHA), Microangiopathies (HUS, TTP, DIC), liver disease, drugs/toxins. Coombs test positive

Hemolytic anemia overview

The problem is that, while the red blood cells are being attacked and destroyed, the bone marrow is unable to replace them at the rate at which they are being depleted. This anemia has many subdivisions and can be acquired or hereditary.

The Most Common Disease You’ve Never Heard Of

Nearly half a billion people on the planet — around one out of every fifteen individuals — are afflicted with a condition that is largely unknown in the popular consciousness.

Resources

Mast Attack

Hemolytic patients display the general symptoms seen in other anemias, including paleness, shortness of breath and fatigue.

All About Blood

Haemolysis may be confused with conditions associated with unconjugated hyperbilirubinaemia, anaemia and reticulocytosis. These include bilirubin conjugation defects, acute blood loss and megaloblastic anaemia.

National Heart, Lung and Blood Institute

There are many types of hemolytic anemia. Treatment and outlook depend on what type you have and how severe it is. The condition can develop suddenly or slowly. Symptoms can range from mild to severe. Hemolytic anemia often can be successfully treated or controlled. Mild hemolytic anemia may need no treatment at all. Severe hemolytic anemia requires prompt and proper treatment, or it may be fatal. Inherited forms of hemolytic anemia are lifelong conditions that may require ongoing treatment. Acquired forms of hemolytic anemia may go away if the cause of the condition is found and corrected.

FPNotebook

Common Causes 1. Lymphoproliferative Disorder 2. Iatrogenic Hemolytic Anemia 3. Medications (Most common cause)a.See Drug-Induced Hemolytic Anemia 4. Connective Tissue Disorders 5. Infectiona. Epstein Barr Virus (Mononucleosis, Cytomegalovirus (CMV, Mycoplasma pneumonia 6. Paroxysmal Cold Hemoglobinuria 7. Favism (G6PD Deficiency)

Life in the FastLane

•Haemolytic anaemia is anemia due to shortened survival of red cells in the circulation •Normal RBC lifespan is 120 days, therefore it is useful to think of hemolytic anemia as representing RBC survival of less than 100 days Shortened lifespan can be due to RBC destruction from: •intravascular or extravascular mechanisms •immune or non-immune-mediated •extrinsic causes or intrinsic RBC abnormalities

Patient

Haemolysis leads to haemolytic anaemia when bone marrow activity cannot compensate for the increased loss of red blood cells (RBCs).