ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

The Different Clinical Manifestations Of Hemolytic Anemias

Updated on January 18, 2014



Hemolytic Crisis


The Different Manifestations

In addition to the general symptomatology of anemia, hemolysis leads to distinctive features which differ from each other in the acute and chronic forms. Chronic hemolysis leads to jaundice, hemolytic facies, chronic leg ulcers, splenomegaly, cholelithiasis, cutaneous pigmentation and Iron overload states. On the other hand, acute hemolytic episodes are characterized by sharp rise in temperature, marked prostration, hemoglobinuria, acute renal failure, disseminated intravascular coagulation and shock. In many cases, the hemolysis is secondary to other underlying conditions such as lymphomas, leukemia, malignancy or dyscollagenosis.

The different manifestations

Jaundice: Hemolytic jaundice is generally mild but at times this can be severe. The degree of jaundice and the extent of hemolysis may not always correlate.

The facies: It is characteristic in hemolytic anemias. There is enlargement of the skull with frontal and parietal bossing. The malar bones are prominent with flattening of the bridge of the nose, widely set eyes and malocclusion to the teeth. The appearance may be mongoloid. This is seen most in thalassemia major. All these changes are caused by enlargement of the marrow tissue.

Chronic leg ulcers: Chronic non-healing ulcers develop the malleoli in severe hemolytic states such as sickle cell anemia and hereditary spherocytosis. These heal when the anemia improves.

Splenomegaly: Splenomegaly is invariably seen in all cases of hemolytic anemia though the size of the spleen may be variable. Massive splenomegaly occurs in thalssemia and this may lead to hypersplenism.

Cholelithiasis: Pigment stones in the biliary tree are occasional complications seen in chronic hemolysis, caused by the excessive presence of bilirubin in bile.

Crisis: The course of chronic hemolytic anemias may be punctuated by acute episodes called crisis. These are aplastic, megaloblastic, hemolytic, sickling and sequestration crisis. Aplastic crisis is due to sudden marrow failure precipitated generally by viral infection. Megaloblastic crisis is produced by folate deficiency resulting from the excessive demand brough about by accelerated erythropoiesis. Hemolytic crisis is rate, which may develop spontaneously or may be an adverse reaction to drugs or viral infections. Sickling crisis occurs in sickle cell anemia when exposed to hypoxic environment. This leads to vascular occlusion of many organs such as lungs, spleen, kidney and brain. In sequestration crisis, sudden splenomegaly develops because of pooling of blood within the organ and severe anemia ensues rapidly.

Melasma (darkening of the skin)


Other Manifestations

Darkening of skin and other Iron overload syndromes: Chronic hemolytic anemias lead to Iron overload due to liberation of excessive Iron which is taken up by the macrophages or deposited in the parenchymal cells of several organs. The absorption of Iron from the G.I tract is also increased in thalassemias. Repeated blood transfusion adds to Iron overload. These result in hemosiderosis characterized by grayish complexion of the skin, cirrhosis of liver, diabetes mellitus and cardiomyopathy.

© 2014 Funom Theophilus Makama


    0 of 8192 characters used
    Post Comment

    No comments yet.


    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at:

    Show Details
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the or domains, for performance and efficiency reasons. (Privacy Policy)
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)