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Define Hemolytic Anemias

The process of abnormal breakdown of red blood cells within the body which may become cause of anemia is called hemolytic anemia. Hence cells are destroyed at faster speed as compared to their making.

There are two types.

Intravascular

Extravascular

According to reticulocyte index

RI= percentage of reticulocyte × actual hct /normal hct

By this formula we can count the reticulocytes because in this disease there is rapid breakdown of red blood cells so our body tries to compensate and make more reticulocytes.

There are many causes of hemolytic anaemia for example for 2 immunity sickle cell anaemia antibiotics for example penicillin kidney disease and hereditary spherocytosis.

So patient having anaemia and splenomegaly.

Define sickle cell Anemia

This is a genetic disorder in which hemoglobin synthesis is mutated and there is something called point mutation in one chain of haemoglobin.

Due to which hemoglobin is defective and such red blood cells when they pass through the blood vessel they got stuck and raptured.

But there are some condition in which these breakdown of red blood cell is more rapid for example when these hemoglobin is defective so it carry less oxygen when there is exposure of he patient to low levels of oxygen or patient is in a very high altitude state means getting less oxygen so in this scenario there is rapid breakdown of red blood cell occurred due to which anaemia symptoms occur in the patient.

Usually sickle cell anaemia patient when they are born they are normal asymptomatic. So these patient must have good amount of Oxygen and along with that their hydration should be good to prevent rapid breakdown of red blood cell to prevent the patient from anemic symptom.

Intravascular hemolysis vs extravascular hemolysis

Intravascular hemolysis vs extravascular hemolysis

Intravascular	Extravascular
Intravascular Hemolysis means the destruction of red blood cells occurs inside the vessel.	Extravascular Hemolysis means destruction of red blood cells outside the vessel in the liver. This occurs due to our body being reactive to our immune system and macropages are produced which are going to eat red blood cell.
Intravascular hemolysis we can find hemoglobin in the urine and hemo-siderin in the urine and micro angiopathy hemolytic anaemia.	Whereas in the extravascular Hemolysis we don't find hemoglobin or hemo-siderin the urine. But we find spherocytes.
In intra vascular Hemolysis we can see haptoglobin level has been low	In extra vascular Hemolysis we see many macropages in spleen.

Explain a case of Hemolytic Anemia

This case which I am discussing I have seen with my eyes actually one patient who was very elderly around 70 years old and he was very pale and she told me that dialysis is going on a weekly basis Mainly she has a history of renal failure.

Now she presented to us that her colour is going to pale day by day so the question was why there is so and she also explain that she has bruises on his body.

When the doctor saw her reports the elderly Hb was just 6.5g/dL and her platelets just 15,000/uL. On smear there was specific cells called schistocytes see.

She was diagnosed with microangiopathic hemolytic Anemia. We sent her for plasma exchange and refrerd to her tertiary care.

Its all about my today's post.

I would like to invite my friends @m-fdo, @jannat12 and @ashkhan to take part in the challenge.