Table of ContentsView AllTable of ContentsDiagnosisCausesTreatment Options
Table of ContentsView All
View All
Table of Contents
Diagnosis
Causes
Treatment Options
The average lifespan of a red blood cell is 120 days. At the end of 120 days, the red blood cell is broken down and the parts of it are recycled to make new ones.When your red blood cells are broken down faster than this, it is calledhemolysis.
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In drug-induced hemolytic anemia, there are several different mechanisms that cause hemolysis when you are exposed to the medication or toxin.
Signs and Symptoms
Signs and symptoms of drug-induced hemolytic anemia are similar to other forms of hemolytic anemia. These symptoms vary slightly based on whether the red blood cell is broken down while in circulation (intravascular hemolysis) or outside the vascular system (predominantly liver and spleen).
Symptoms may include:
To diagnose hemolytic anemias, it is important for either your hematologist or a pathologist to look at your red blood cells under the microscope. This is called a peripheral blood smear.A red blood cell normally looks round, similar to a donut under the microscope. When a red blood cell is destroyed prematurely, it becomes fragmented or shaped like a sphere or globe.
Some medications cause an immune hemolytic anemia similar to autoimmune hemolytic anemia. If you have this, a test called the direct antiglobulin test (DAT or Direct Coombs) will be positive, indicating that your immune system is attacking and destroying your red blood cells inappropriately.
Otherwise, there are no specific tests to determine if your medication is the cause of your hemolytic anemia. In general, the diagnosis is confirmed if your anemia improves after discontinuing the medication.
There are several medications associated with drug-induced hemolytic anemia. The most common culprits are:
A related condition is aglucose-6-phosphate dehydrogenase (G6PD) deficiency. In this type of anemia, you are missing a key enzyme (chemical) in the red blood cell. If you are exposed to certain medications like sulfa antibiotics, your red blood cells may hemolyze, causing anemia.
If you have G6PD deficiency, it is important for you to know whatmedications/foods you should avoid.
First, the medication/toxin that is causing hemolytic anemia should be stopped. Blood transfusions can be given if necessary.
If hemolysis is severe, it may cause kidney injury. Fortunately, this is typically temporary and improves once the hemolysis resolves, though some may require dialysis for a period of time.
A Word From Verywell
It may seem strange to learn that a medication you were taking for another medical condition caused your anemia. Fortunately, removing the offending medication will keep the hemolysis from worsening.
It is important to discuss with your physician what medication caused the anemia so that you can avoid using it in the future.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Arias CF, Arias CF.How do red blood cells know when to die?.R Soc Open Sci. 2017;4(4):160850. doi:10.1098/rsos.160850Genetic and Rare Diseases Information Center.Hereditary spherocytosis.Genetic and Rare Diseases Information Center.Hemolytic anemia due to red cell pyruvate kinase deficiency.Genetic and Rare Diseases Information Center.Autoimmune hemolytic anemia.National Library of Medicine: MedlinePlus.Hemolytic disease of the newborn.National Library of Medicine: MedlinePlus.Drug-induced immune hemolytic anemia.Lab Tests Online.Anemia testing.Lab Tests Online.Reticulocytes.Ford J.Red blood cell morphology.Int J Lab Hematol. 2013;35(3):351-357. doi:10.1111/ijlh.12082Zantek ND, Koepsell SA, Tharp DR Jr, Cohn CS.The direct antiglobulin test: a critical step in the evaluation of hemolysis.Am J Hematol.2012;87(7):707-9. doi:10.1002/ajh.23218Pierce A, Nester T.Pathology consultation on drug-induced hemolytic anemia.Am J Clin Pathol. 2011;136(1):7-12. doi:10.1309/AJCPBVLJZH6W6RQMYoungster I, Arcavi KA, Schechmaster R, et al.Medications and glucose-6-phosphate dehydrogenase deficiency: an evidence-based review.Drug Saf. 2010;33(9):713-26. doi:10.2165/11536520-000000000-00000Brodsky R.Drug-induced hemolytic anemia. UpToDate.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Arias CF, Arias CF.How do red blood cells know when to die?.R Soc Open Sci. 2017;4(4):160850. doi:10.1098/rsos.160850Genetic and Rare Diseases Information Center.Hereditary spherocytosis.Genetic and Rare Diseases Information Center.Hemolytic anemia due to red cell pyruvate kinase deficiency.Genetic and Rare Diseases Information Center.Autoimmune hemolytic anemia.National Library of Medicine: MedlinePlus.Hemolytic disease of the newborn.National Library of Medicine: MedlinePlus.Drug-induced immune hemolytic anemia.Lab Tests Online.Anemia testing.Lab Tests Online.Reticulocytes.Ford J.Red blood cell morphology.Int J Lab Hematol. 2013;35(3):351-357. doi:10.1111/ijlh.12082Zantek ND, Koepsell SA, Tharp DR Jr, Cohn CS.The direct antiglobulin test: a critical step in the evaluation of hemolysis.Am J Hematol.2012;87(7):707-9. doi:10.1002/ajh.23218Pierce A, Nester T.Pathology consultation on drug-induced hemolytic anemia.Am J Clin Pathol. 2011;136(1):7-12. doi:10.1309/AJCPBVLJZH6W6RQMYoungster I, Arcavi KA, Schechmaster R, et al.Medications and glucose-6-phosphate dehydrogenase deficiency: an evidence-based review.Drug Saf. 2010;33(9):713-26. doi:10.2165/11536520-000000000-00000Brodsky R.Drug-induced hemolytic anemia. UpToDate.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Arias CF, Arias CF.How do red blood cells know when to die?.R Soc Open Sci. 2017;4(4):160850. doi:10.1098/rsos.160850Genetic and Rare Diseases Information Center.Hereditary spherocytosis.Genetic and Rare Diseases Information Center.Hemolytic anemia due to red cell pyruvate kinase deficiency.Genetic and Rare Diseases Information Center.Autoimmune hemolytic anemia.National Library of Medicine: MedlinePlus.Hemolytic disease of the newborn.National Library of Medicine: MedlinePlus.Drug-induced immune hemolytic anemia.Lab Tests Online.Anemia testing.Lab Tests Online.Reticulocytes.Ford J.Red blood cell morphology.Int J Lab Hematol. 2013;35(3):351-357. doi:10.1111/ijlh.12082Zantek ND, Koepsell SA, Tharp DR Jr, Cohn CS.The direct antiglobulin test: a critical step in the evaluation of hemolysis.Am J Hematol.2012;87(7):707-9. doi:10.1002/ajh.23218Pierce A, Nester T.Pathology consultation on drug-induced hemolytic anemia.Am J Clin Pathol. 2011;136(1):7-12. doi:10.1309/AJCPBVLJZH6W6RQMYoungster I, Arcavi KA, Schechmaster R, et al.Medications and glucose-6-phosphate dehydrogenase deficiency: an evidence-based review.Drug Saf. 2010;33(9):713-26. doi:10.2165/11536520-000000000-00000Brodsky R.Drug-induced hemolytic anemia. UpToDate.
Arias CF, Arias CF.How do red blood cells know when to die?.R Soc Open Sci. 2017;4(4):160850. doi:10.1098/rsos.160850
Genetic and Rare Diseases Information Center.Hereditary spherocytosis.
Genetic and Rare Diseases Information Center.Hemolytic anemia due to red cell pyruvate kinase deficiency.
Genetic and Rare Diseases Information Center.Autoimmune hemolytic anemia.
National Library of Medicine: MedlinePlus.Hemolytic disease of the newborn.
National Library of Medicine: MedlinePlus.Drug-induced immune hemolytic anemia.
Lab Tests Online.Anemia testing.
Lab Tests Online.Reticulocytes.
Ford J.Red blood cell morphology.Int J Lab Hematol. 2013;35(3):351-357. doi:10.1111/ijlh.12082
Zantek ND, Koepsell SA, Tharp DR Jr, Cohn CS.The direct antiglobulin test: a critical step in the evaluation of hemolysis.Am J Hematol.2012;87(7):707-9. doi:10.1002/ajh.23218
Pierce A, Nester T.Pathology consultation on drug-induced hemolytic anemia.Am J Clin Pathol. 2011;136(1):7-12. doi:10.1309/AJCPBVLJZH6W6RQM
Youngster I, Arcavi KA, Schechmaster R, et al.Medications and glucose-6-phosphate dehydrogenase deficiency: an evidence-based review.Drug Saf. 2010;33(9):713-26. doi:10.2165/11536520-000000000-00000
Brodsky R.Drug-induced hemolytic anemia. UpToDate.
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