Acute hemolysis in a patient with hemolytic anemia: case report and literature review.

Abstract

Background and objectives: Hemolytic anemias are common in the medical world and there is little existing literature on the diversity of etiologies and investigation methods of these pathologies. This implies the difficulty in clarifying the cause that triggers acute hemolysis in a patient with chronic anemia of unknown cause. Therefore, in-depth investigation is extremely important to reach the correct diagnosis, with the aim of improving the quality of life of a patient with chronic anemia. The objective of the study was to report the case of a patient with chronic anemia, of unknown cause, who progressed to an acute hemolytic crisis after an episode of urinary tract infection. In addition to elucidating how the investigation was based on manifestations, clinical history and laboratory tests, how other diagnostic hypotheses were ruled out and how the diagnosis and treatment were carried out. Case report: Female patient, 23 years old, who presented with severe jaundice and hepatosplenomegaly, after a symptomatic UTI (fever, dysuria and urinary frequency) progressing with incoercible vomiting and a fever peak of 38 degrees. His personal history was anemia since childhood, requiring annual transfusions. After years of clinical evolution, the patient's case was investigated and the diagnostic hypothesis was hemolytic anemia, the most likely etiology of which would be hereditary elliptocytosis, based on clinical and complementary examination. During clinical hospitalization, the condition was stabilized and after compensation, the patient was referred to the hematologist for follow-up and evaluation of the indication for splenectomy. Conclusion: Therefore, it is important to clearly understand what hemolytic anemia is and how it relates to other diseases. It is of interest to this work to elucidate the entire case report presented with the help of the literature on this subject, in order to provide a better study.