Types Of Hemolysis And How To Recognize Them: This blog is all about the red blood cell disorder that is hemolysis, and it causes which type of anemia and why? What are its types, symptoms, and clinical features, also its morphology?
What is Hemolysis?
The word Hemolysis has two parts, hem means blood, and lysis means breakdown, so then it means the breakdown of blood cells (Red blood cells).
Its breakdown will be due to different causes that include trauma or any other abnormality.
The hemolysis may be Physiologic or Pathologic, it depends on the cause why it occurs?
Physiologically, it occurs in the spleen, bone marrow, and liver.
Types of Hemolysis
On the basis of the site where it occurs, two types of hemolysis are there. Both of these are given below:
1) Intravascular Hemolysis
2) Extra-vascular Hemolysis
Extra-vascular Hemolysis ( Types Of Hemolysis )
Extravascular Hemolysis is the destruction of premature blood cells inside the phagocytes.
As if it is persistent, then it may lead to the hyperplasia of phagocytes.
As hemoglobin escapes from phagocytes, then the plasma level of hemoglobin increases, which binds with Haptoglobin (Alpha-2 globulin),
leading to a decrease in the level of free haptoglobin.
Clinical features of Extravascular hemolysis
Following are the clinical features of extravascular hemolysis:
- Anemia
- Splenomegaly
- Jaundice
Intravascular Hemolysis ( Types Of Hemolysis )
When the blood cell destruction occurs in the circulation, then it is termed Intravascular hemolysis.
All of the content will be released in the plasma when lysis occurs in the circulation.
It leads to a low level of haptoglobin, so then hemoglobin will be free and in an unbonded form.
Then, the free hemoglobin will oxidize to methemoglobin.
Red-brown is the color of methemoglobin.
As the reabsorption of methemoglobin occurs in proximal tubules, but few amounts of methemoglobin excrete out with urine, giving urine a Red-Brown Color.
The destruction also leads to the increase in iron level, which then accumulates in tubular cells, which give rise to renal Hemosiderosis.
Causes of Intravascular Hemolysis
The causes of intravascular hemolysis include Mechanical injury, Complement fixation, Intravascular parasites, and Exogenous toxic factors.
Mechanical injury includes trauma that may be due to Heart valves, Thrombotic narrowing of microcirculation, Physical trauma due to marathon running.
Complement fixation means the recognization of antigen on the membrane of RBC by the antibody.
Clinical features of Intravascular Hemolysis
Following are the clinical features of Intravascular hemolysis:
- Anemia
- Hemoglobinemia
- Hemoglobinuria
- Hemosiderinuria
- Jaundice
Which anemia does hemolysis cause?
As hemolysis is the destruction of blood cells, so it's clear that the anemia in which the cellular destruction occurs will be due to hemolysis.
That anemia is called Hemolytic anemia, which has different types, which include immune hemolytic anemia, drug-induced hemolytic anemia, autoimmune hemolytic anemia, and many others.
Morphology of Hemolytic anemia
Anemia or the low oxygen level in tissues leads to an increase in the erythropoietin level, which then causes an increase of red cell precursors called Normoblast.
The increased level of erythropoiesis will lead to an increase in reticulocytosis in peripheral blood.
The phagocytosis of RBC leads to hemosiderosis that mostly occurs in the spleen, liver, and bone marrow.
If the anemia is severe, then extramedullary hematopoiesis starts that occur in the liver, bone marrow, and spleen.
The increased biliary excretion of bilirubin leads to the formation of pigment gall stones called Cholelithiasis.
Conclusion-Types Of Hemolysis
This whole blog is all about hemolysis, its types, causes, clinical features, and morphology, also hemolytic anemia.
The names of different types of hemolytic anemia, caused by hemolysis are in this blog.
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