Hemolytic anemia risk factors

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Shyam Patel [2]

Risks factors for hemolytic anemia involve insults to red blood cells or defects within red blood cells. Broadly, the risks factors can be categorized as oxidative stress, mechanical injury, and genetic conditions.

Oxidative stress in the setting of G6PD deficiency:^[1]

• Use of primiquine for malaria treatment
• Use of dapsone for PCP or leprosy treatment
• Consumption of fava beans as part of a Mediterranean diet
• Use of sulfa drugs like trimethoprim-sulfamethoxazole for treatment of skin, urinary tract, or other infections
• Use of phenazopyridine for alleviating symptoms of dysuria
• Use of nitrofurantoin for treatment of a urinary tract infection

Mechanical damage-related risk factors:

• Presence of a mechanical mitral or aortic valve^[2]
• High shear stress from extracorporeal membrane oxygenation (ECMO) circuit in patients undergoing cardiac surgery or with hypoxic respiratory failure^[2]
• Presence of left ventricular assist device for end-stage heart failure^[3]

Genetic conditions affecting red blood cells:

• Hereditary spherocytosis
• Hereditary elliptocytosis
• Paroxysmal nocturnal hemoglobinuria
• Sickle cell disease^[4]

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