Toxic hemolytic anemia

Toxic hemolytic anemia, or hemolysis of erythrocytes can cause many chemicals and bacterial toxins.

Causes of toxic hemolytic anemia

Hemolysis causes such chemicals as:

• arsenious hydrogen;
• lead;
• copper salts (due to inhibition of pyruvate kinase activity and some other erythrocyte enzymes);
• chlorates of potassium and sodium;
• resorcinol;
• nitrobenzene;
• aniline.

Cases of hemolytic anemia after a sting of bees, scorpions, spiders, snakes (in particular, vipers) are described. It is very common and dangerous poisoning with mushrooms, especially morels, fraught with severe acute hemolysis.

[1], [2], [3], [4]

The mechanism of hemolysis of red blood cells

The mechanism of hemolysis in toxic hemolytic anemia can be different. Sometimes hemolysis develops due to a sharp oxidative effect (as in the case of enzymatic anemia), a violation of the synthesis of porphyrins, the production of autoimmune factors, etc. Most often, with toxic anemia, intravascular hemolysis is observed. Hemolytic anemia can also occur with infectious diseases. For example, malarial plasmodium is able to penetrate into the erythrocytes, which are then eliminated by the spleen, and Clostridium welchii secretes a-toxin-lecithinase, interacting with the membrane lipids of erythrocytes with the formation of hemolytically active lysolecithin. Other variants are also possible: absorption of bacterial polysaccharides on erythrocytes followed by the formation of autoantibodies, destruction by the bacteria of the surface layer of the erythrocyte membrane,

Symptoms of toxic hemolytic anemia

Depending on the course, acute and chronic toxic hemolytic anemia is isolated. In acute toxic hemolytic anemia, intravascular hemolysis arises, manifested by hemoglobinemia, hemoglobinuria, and sometimes accompanied by collapse and anuria. One of the most vivid models of acute toxic hemolysis is the so-called gyrometry syndrome, which occurs as a result of poisoning with fungi of the genus Gyromitra from the group of morel mushrooms - by lines (Gyromitra esculenta, Stitch ordinary). In addition to acute intravascular hemolysis (DVS-syndrome), gyrometry syndrome includes:

• gastrointestinal symptoms, manifested in the first 6-24 hours after poisoning and lasting from 1 to 3 days;
• neurologic syndrome with asthenia and a sharp headache;
• hyperthermia;
• hepatitis with pronounced cytolysis.

With this form of acute hemolysis, a lethal outcome is very likely.

Treatment of toxic hemolytic anemia

Treatment of toxic hemolytic anemia consists in stopping contact with the toxic agent or in eliminating it (including if possible with the help of an appropriate antidote), and for infectious diseases - in adequate antibacterial or antifungal therapy. In severe anemia, substitution therapy is indicated. In addition, the patient needs emergency post-dandruff therapy (treatment of kidney failure, hepatitis, neurological syndrome).