My blood test says: "hemolysis 4+ abnormal." What does the 4+ mean?
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The abnormal breakdown of the body's red blood cells is known as hemolysis. The presence of certain diseases can contribute to the development of this condition, which leads to hemolytic anemia. Treatment for hemolysis, and the subsequent development of hemolytic anemia, is dependent on the type and reason for the anemia. Due to the serious nature of potential complications associated with this condition, individuals who become symptomatic should seek immediate medical attention.
Naturally produced in bone marrow, the lifespan of a red blood cell is nearly three months before it breaks down. As new blood cells are introduced into the blood stream, the spleen filters the dying cells from the circulatory system. The presence of certain diseases sometimes instigates a disruption in the circulatory system adversely affecting red blood cells and their life cycle. When disease forces the premature death of red blood cells, the bone marrow is forced to compensate by increasing red blood cell production. The rate at which the bone marrow is able to make up for the loss determines red blood cell levels, which can diminish quickly.
There are a variety of conditions which may contribute to the development of hemolysis. Certain medications, infections, and immune system responses to illness may contribute to the premature death of red blood cells. Hereditary conditions, such as sickle cell disease and G6PD deficiency disorder, may also contribute to the development of hemolysis. Exposure to poisons and toxins may adversely affect an individual’s red blood cell levels, causing a disruption of the balance of purging and production.
Compensated hemolysis occurs when the bone marrow is able to restore balance during the early stages of red blood cell disruption, ultimately, preventing the onset of anemia. Hemolytic anemia manifests when the bone marrow is unable to adequately compensate for the loss. There are multiple types of hemolytic anemia and each is named for the initial cause of the red blood cell failure and its contributing factors.
There are specific defects associated with each form of anemia and these are divided into two categories. Internal defects within the red blood cell are congenital, or present at birth, and involve protein abnormalities or imbalances. External defects result from outside influences and may include infection, adverse reactions to medications, and blood clots.
Individuals experiencing hemolysis-induced anemia may develop a variety of symptoms. An accelerated heart rate, shortness of breath, or pronounced fatigue may be indicative of hemolytic anemia. Those whose urine is dark in color or whose skin adopts a yellowish hue, as associated with jaundice, may also be symptomatic.
There are a variety of diagnostic tests used to confirm the presence of hemolysis and hemolytic anemia. An individual who is suspected of having either condition may undergo a urinalysis and extensive blood testing. An erythrocyte count, also known as a red blood cell count, is performed in addition to tests that measure levels of oxygen carrying hemoglobin, proteins such as haptoglobin, and bile pigments such as bilirubin. The lifespan of existing red blood cells may be subjected to direct monitoring, which involves the administration of small amounts of radioactive material to the cells in a process known as radioactive tagging.
Treatment for the premature breakdown of red blood cells is dependent on the type and origin of the individual’s anemia. Corticosteroids and mineral supplementation may be administered to boost red blood cell production. Complications associated with hemolysis and hemolytic anemias may include infection, kidney failure, and cardiovascular failure. Prognosis associated with this condition is entirely dependent on the individual and severity of his or her anemia.
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