The Acute Hemolytic Anemias: The Importance of Emergency Diagnosis and Management

Jennifer J. Robertson, Elizabeth Brem, Alex Koyfman

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Hemolytic anemias are defined by the premature destruction of red blood cells. These anemias have many causes that are mostly due to chronic diseases, but, occasionally, cases of acute life-threatening hemolysis can occur. Objective: The objectives of this article were to review the pathophysiology of hemolytic anemias, to discuss the general emergency department (ED) evaluation, and to discuss the assessment and treatment of important and "cannot miss" hemolytic diseases. Discussion: Because hemolytic anemias are rarely seen, the emergency physician may consider a patient's anemia as due to blood loss rather than hemolysis, and the workup and treatment may not be appropriate. The primary goal for the emergency provider is to resuscitate, but he or she also must recognize that a hemolytic process is present. Appropriate laboratory work and specialist consultation should be obtained. While focused treatment is rarely necessary in the ED, the avoidance of certain treatments, such as early platelet transfusion in thrombotic thrombocytopenic purpura, may be necessary. Conclusions: Hemolytic anemias are rare, but should still be considered in the ED differential diagnosis of low hemoglobin. Emergency physicians should first resuscitate, but should also be able to identify the presence of hemolysis and obtain the appropriate laboratory tests. Occasionally, specific treatments are needed but should be discussed in conjunction with a specialist.

Original languageEnglish (US)
JournalJournal of Emergency Medicine
DOIs
StateAccepted/In press - Jul 10 2016

Fingerprint

Hemolytic Anemia
Emergencies
Hemolysis
Hospital Emergency Service
Anemia
Physicians
Therapeutics
Thrombotic Thrombocytopenic Purpura
Platelet Transfusion
Hemoglobins
Differential Diagnosis
Chronic Disease
Referral and Consultation
Erythrocytes

Keywords

  • Anemias
  • Hemolysis

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

The Acute Hemolytic Anemias : The Importance of Emergency Diagnosis and Management. / Robertson, Jennifer J.; Brem, Elizabeth; Koyfman, Alex.

In: Journal of Emergency Medicine, 10.07.2016.

Research output: Contribution to journalArticle

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