Inherited and Acquired Hemolytic Anemias

Hemolytic anemia is a disorder whereby the red blood cells are destroyed (hemolysis)
faster than they are made. Conditions that cause hemolytic anemia include autoimmune
disorders, thalassemia or sickle cell anemia, infections or bone marrow failure, and blood
transfusion side effects. Anemia affects a third of the global population, contributing to increased
mortality and morbidity, impaired neurological development, and decreased work productivity.

Etiologies for Inherited and Acquired Hemolytic Anemias

Research findings have established that inherited hemolytic anemia occurs when the gene
for the condition is passed to children by their parents. The three main etiologies causing
inherited hemolytic anemia include hemoglobin disorders, red blood cells membrane disorders,
and red blood cells enzyme disorders (Chaparro & Suchdev, 2019). Acquired hemolytic anemia
is developed when red blood cells produce normal red blood cells that are later destroyed. The
main etiologies of acquired hemolytic anemia include certain bacterial or viral infections, blood
cancers, medicines such as antimalarial drugs, penicillin, acetaminophen, or sulfa medicines,
tumors, hypersplenism, and autoimmune disorders such as ulcerative colitis, lupus, or
rheumatoid arthritis, among others (Chaparro & Suchdev, 2019). Inherited hemolytic anemia is a
rare illness is characterized by the premature destruction of red blood cells and anemia due to
intrinsic defects of the red blood cells.
Pathophysiological Mechanisms of Inherited and Acquired Hemolytic Anemias
Senescent red blood cells lose their membrane and are primarily cleared from circulation
by the phagocytic cells of the liver, bone marrow, spleen, and reticuloendothelial system
(Chaparro & Suchdev, 2019). The heme oxygenase system primarily breaks down hemoglobin in
the cells. The iron is conserved and reused while heme is degraded to form delirium conjugated

3
to bilirubin glucuronide in the liver and expelled in the bile (Chaparro & Suchdev, 2019).
Hemolysis may be chronic, acute, or episodic, and it may also be intravascular, extravascular, or
both.
Understanding the complex and varied etiology and pathophysiological mechanisms of
hemolytic anemias is essential for establishing efficient interventions to address the context-
specific causes of these diseases and monitoring their control programs. There is a need for
further research to explore the contribution of chronic and infectious diseases, roles played by
additional nutritional deficiencies, and the significance of genetic hemoglobin disorders in
different populations.

4

Reference

Chaparro, C. M., & Suchdev, P. S. (2019). Anemia epidemiology, pathophysiology, and etiology
in low‐and middle‐income countries. Annals of the New York Academy of
Sciences, 1450(1), 15-31.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6697587/pdf/nihms-1040291.pdf