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Hemolytic Anemias in Children

Pediatric Red Cell Destruction Disorders

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Çocuk Sağlığı ve Hastalıkları department. Book Appointment →

What is Hemolytic Anemias in Children?

Premature destruction of red blood cells, with reduced erythrocyte lifespan (<120 days).

Hereditary causes: membrane defects (hereditary spherocytosis, elliptocytosis), enzymopathies (G6PD deficiency, pyruvate kinase), hemoglobinopathies (sickle cell, thalassemia).

Acquired causes: autoimmune hemolytic anemia (warm, cold), microangiopathic (HUS, TTP, DIC), drug-induced, infections (malaria, mycoplasma), mechanical (prosthetic valves).

Compensation: bone marrow can increase erythropoiesis 6-8 fold; failure leads to anemia.

Symptoms

Pallor, fatigue, weakness, decreased exercise tolerance.
Jaundice (especially scleral icterus, conjugated hyperbilirubinemia).
Dark urine (hemoglobinuria) in intravascular hemolysis.
Splenomegaly (extravascular hemolysis).
Tachycardia, dyspnea, congestive heart failure in severe anemia.
Hereditary spherocytosis: aplastic crisis with parvovirus B19.
Sickle cell: vaso-occlusive crises, dactylitis, acute chest syndrome.
Cholelithiasis (pigmented stones from chronic hemolysis).

Risk Factors

Family history (hereditary disorders).
Ethnic predisposition: thalassemia (Mediterranean), sickle cell (African), G6PD (Mediterranean, African, Asian).
Drug exposure (G6PD: primaquine, dapsone, sulfonamides, fava beans).
Recent infection (mycoplasma → cold AIHA, malaria).
Autoimmune disease, lymphoproliferative disorders (warm AIHA).

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Pallor with jaundice or scleral icterus in child.
  • Dark/cola-colored urine.
  • Family history of hemolytic anemia.
  • Recurrent jaundice with viral infections.
  • Failure to thrive with anemia.

Treatment Methods

01
Diagnosis: CBC, reticulocyte count (elevated), peripheral smear, indirect bilirubin (elevated), LDH (elevated), haptoglobin (low), direct Coombs test, urinalysis.
02
Specific tests: hemoglobin electrophoresis, osmotic fragility, G6PD assay, EMA binding for spherocytosis.
03
Hereditary spherocytosis: folic acid, transfusion if severe; splenectomy after age 5 (with vaccinations) for moderate-severe.
04
G6PD deficiency: avoid trigger drugs/foods, supportive care during hemolytic episodes.
05
Sickle cell disease: hydroxyurea, regular transfusions, hematopoietic stem cell transplant, gene therapy (newer).
06
Thalassemia major: chronic transfusions + iron chelation (deferasirox), HSCT curative.
07
Autoimmune hemolytic anemia: corticosteroids first-line, IVIG, rituximab, splenectomy in refractory.
08
Folic acid supplementation in chronic hemolysis.
09
Cholelithiasis monitoring; cholecystectomy if symptomatic.

Which Department to Visit?

You can visit our Çocuk Sağlığı ve Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.