Hemolysis

From IKE

Contents 1 Basics 1.1 Defective enzymes 1.2 Defective membranes 1.3 Defective hemoglobin 2 Diagnosis 3 Resources

Basics

• The breakdown of red blood cells
• RBC destruction could be increased by:
  1. abnormalities outside the RBC (e.g., infection, runaway clotting, etc)
  2. abnormalities of the RBC, such as

Defective enzymes

• Red blood cells depend on the glycolytic pathway to generate the ATP energy they use
• Energy problems mean that the red blood cell cannot run membrane ion pumps
• The most common defect is pyruvate kinase deficiency, which involves pyruvate kinase

Defective membranes

• In diseases such as spherocytosis, red blood cells take on a spherical shape, and cannot move through vessels as easily
• Cells are then more prone to damage and uptake in the spleen

Defective hemoglobin

• A good test is the hemoglobin electrophoresis to pick up abnormal chains or abnormal chain ratios. This test would pick up thalassemia or sickle cell anemia (EXAM)
• Examples of this are thalassemia and sickle cell anemia

In sickle cell anemia, in a low oxygen environment, the confirmation of the hemoglobin is such that some oily shit messes up the shape of the cell and makes it sickle-shaped (EXAM)

Diagnosis

• Classically, a Coomb's test
• A peripheral blood smear could also be used
• If the smear is abnormal, that argues in favour of a hemolytic anemia
• If the smear is normal, it ain't hemolytic anemia

Resources

• Quarter 3 Biochemistry Lecture notes (PDF)
• Medical Encyclopedia: Hemolysis
• anemia, hemolytic