Hemolytic anemia caused by hyperthermia
Introduction
Introduction to hemolytic anemia caused by high temperature High temperatures can directly cause red blood cell damage in the blood circulation. High temperature causes hemolytic anemia to be the most common in burns. Hemorrhagic anemia can be caused by II and III degree burns with an area of more than 15%. Can be expressed as low back pain, brown urine, skin jaundice, acute hemolysis and dehydration electrolyte disorders, acute hemolysis after anemia can last for several weeks and other symptoms. basic knowledge Sickness ratio: 0.0001% Susceptible people: good for burn patients Mode of infection: non-infectious Complications: renal failure, shock, hypertension, pericarditis, cardiomyopathy, anemia
Cause
Causes of hemolytic anemia caused by high temperature
(1) Causes of the disease
High temperatures can directly cause red blood cell damage in the blood circulation.
(two) pathogenesis
Acute intravascular hemolysis can occur within 24 to 48 hours after extensive II or III degree burns. The degree of hemolysis is related to the area of burns. Anemia after severe burns is multifactorial. It is closely related to the composition, function and function of erythrocyte membrane. Correlation, when the temperature exceeds 49 °C, the erythrocyte membrane contraction protein will be denatured, and the elasticity and deformability of the membrane will be reduced, so the red blood cells are easily destroyed. However, in some patients with hereditary hemolytic anemia, the above changes can occur when the temperature reaches 46 °C. Changes in plasma lipids may also be associated with hemolysis. According to reports in the literature, serum free fatty acids increased during burn shock, and erythrocyte membrane ethanolamine phospholipid (PE) content decreased significantly. PE plays an important role in membrane lipid and membrane matrix. Decreased PE content is one of the factors that cause red blood cells to be easily destroyed. After severe burns, a large amount of free radicals are generated. Although red blood cells have an anti-reactive oxygen protection system, when the antioxidant capacity is insufficient to fight free radicals, membrane lipid peroxidation can be caused. To make the erythrocyte membrane hard and easy to break, in addition, at high temperatures, the erythrocyte membrane calcium pump (Ca2, Mg2-ATPase) function Poor, the intracellular calcium concentration is increased, too much Ca2 binds to the cytoskeletal protein, making the membrane hard or brittle and easily destroyed. The damage of red blood cells after burn is reversible. As for the longer-term anemia after acute hemolysis, some people think that May be a tumor necrosis factor-mediated chronic anemia.
Prevention
Prevention of hemolytic anemia caused by high temperature
Prevent burns and burns. Patients with severe anemia, acute hemolysis, chronic hemolysis combined with crisis should be absolutely bed rest; acidic foods should not be eaten during hemolysis (such as pork, beef, chicken, egg yolk, squid, squid, oysters, dried squid, shrimp, white rice, flour) Products, peanuts, beer, etc., should choose alkaline foods such as tofu, kelp, milk and various vegetables and fruits; during the treatment of immunosuppressive agents should pay attention to the skin care of the mucous membrane.
Complication
Complications of hemolytic anemia caused by high temperature Complications, renal failure, shock, hypertension, pericarditis, cardiomyopathy, anemia
The most common complications are renal failure, shock and heart failure, hemolytic crisis, electrolyte imbalance, shock, heart and kidney failure, early detection of the condition, and active treatment. The clinical manifestations of chronic renal failure are caused by the retention of a variety of toxins and metabolites. They involve systemic renal failure systems. Early manifestations are weakness, poor mental condition, and later digestive symptoms such as poor appetite, nausea, and vomiting. Further development of the disease showed anemia, palpitations, itchy skin, abnormal limbs, and numbness. Late invasive cardiovascular system, hypertension, pericarditis, cardiomyopathy, heart rhythm disorder and heart failure; severe anemia invading the blood system.
Symptom
Symptoms of hemolytic anemia caused by high temperature Common symptoms Brown urinary jaundice dehydration diffuse low back pain
Can be expressed as low back pain, brown urine, skin jaundice, acute hemolysis and dehydration electrolyte disorders, acute hemolysis after anemia can last for several weeks and other symptoms.
Examine
Examination of hemolytic anemia caused by high temperature
1. Peripheral blood can be seen in spherical cells, spine cells and ruptured red blood cells and their fragments. The degree of anemia is parallel to the burn area. In severe cases, up to 30% of circulating red blood cells are destroyed.
2. Erythrocyte osmotic fragility and mechanical fragility increase.
Diagnosis
Diagnosis and diagnosis of hemolytic anemia caused by high temperature
1 anemia and reticulocyte increase: such as hemorrhagic, iron deficiency or early recovery of megaloblastic anemia;
2 non-bilirubin urinary jaundice: such as familial non-hemolytic jaundice (Gilbert syndrome, etc.);
3 young erythrocytic anemia with mild reticulocyte enlargement: such as bone marrow metastasis. Although the above situation is similar to hemolytic anemia, the essence is not hemolysis, lack of evidence for three aspects of laboratory diagnosis of hemolysis, so it is easy to identify. Ineffective red blood cell formation with both anemia and non-bilirubin urinary jaundice, is a special extravascular hemolysis, should be noted.
