Mechanisms of hemolysis and anemia associated with acute antepartum pyelonephritis

S. M. Cox, P. Shelburne, R. Mason, S. Guss, F. G. Cunningham

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Anemia develops in about a fourth of women whose pregnancy is complicated by pyelonephritis, although its exact mechanism has not been defined clearly. In this study of 18 women with antepartum pyelonephritis, although only a third had anemia (hematocrit <30 vol/dl), there was evidence for hemolysis in all 18. Specifically there was a mean decrease in hematocrit of 5 vol/dl from admission to discharge. With scanning electron microscopy, we compared erythrocyte morphologic aberrations that were found in women with renal infection with those of normally pregnant women, and the former had significantly increased proportions of echinocytes in particular, but schistocytes and spherocytes were increased also (total 10.3% vs 1.4%, p < 0.0001). These changes, especially echinocytosis, have been induced in vitro by lipopolysaccharide, and they are known to lead to premature red blood cell destruction in vivo. We conclude that hemolysis with subsequent anemia in pregnant women with pyelonephritis is caused by lipopolysaccharide-induced red blood cell membrane damage.

Original languageEnglish (US)
Pages (from-to)587-590
Number of pages4
JournalAmerican Journal of Obstetrics and Gynecology
Volume164
Issue number2
StatePublished - 1991

Fingerprint

Pyelonephritis
Hemolysis
Anemia
Erythrocytes
Hematocrit
Lipopolysaccharides
Pregnant Women
Spherocytes
Electron Scanning Microscopy
Cell Membrane
Kidney
Pregnancy
Infection

Keywords

  • Anemia
  • Hemolysis
  • Pyelonephritis

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Mechanisms of hemolysis and anemia associated with acute antepartum pyelonephritis. / Cox, S. M.; Shelburne, P.; Mason, R.; Guss, S.; Cunningham, F. G.

In: American Journal of Obstetrics and Gynecology, Vol. 164, No. 2, 1991, p. 587-590.

Research output: Contribution to journalArticle

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