What is the role of hemolysis in the pathogenesis of hemolytic anemia?

Updated: May 27, 2021
  • Author: Srikanth Nagalla, MD, MS, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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Hemolysis can be due to hereditary and acquired disorders. [1, 2]  The etiology of premature erythrocyte destruction is diverse and can be due to conditions such as intrinsic membrane defects, abnormal hemoglobins, erythrocyte enzymatic defects, immune destruction of erythrocytes, mechanical injury, and hypersplenism.

Hemolysis may be an extravascular or an intravascular phenomenon. Autoimmune hemolytic anemia and hereditary spherocytosis are examples of extravascular hemolysis because the red blood cells are destroyed in the spleen and other reticuloendothelial tissues. [3] Intravascular hemolysis occurs in hemolytic anemia due to the following:

Hemolysis may also be intramedullary, when fragile red blood cell (RBC) precursors are destroyed in the bone marrow prior to release into the circulation. Intramedullary hemolysis occurs in pernicious anemia and thalassemia major.

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