Q: My 35 years old sister is suffering from haemolytic anaemia. Initially she suffered from pain in her tooth with pus formation in it. She got treated for the same but later on she felt some swellings behind her ear and in the head and collapsed last week. Her total leucocyte count (TLC) is 16000 and haemoglobin (Hb) is 3.6 and has jaundice of 4.2. The doctors tried to transfuse blood, but said that her body is rejecting it. They are still in the process of finding out the exact reason for haemolytic anaemia after, which they can decide the line of treatment. However, they have started oral treatment with iron tablets, steroidsbut her body is showing little or no improvement. Please advise if this problem of haemolytic anameia is curable? If yes, then what should be the course of action?

A:Anaemia is a condition in, which the number of red blood cells or the amount of haemoglobin is below normal for age and sex of the individual. It is defined as a decrease in red blood cell (RBC) mass and is usually discovered and quantified by measurement of the RBC count, haemoglobin (Hb) concentration, and hematocrit (Hct). Anaemia is suggested in males with Hb levels less than 13.0 g/dl and in females with Hb levels less than 12.0 g/dl (less than 11.5 g/dl in pregnant women). It may be due to decreased production of red blood cells, blood loss (haemorrhage) or red cell breakdown (hemolysis). Haemolysis is the premature break down of red blood cells. This can lead to anaemia called haemolytic anaemia when the bone marrow cannot compensate for the red cell loss. Clinical presentation of a patient depends on whether the onset of haemolysis is gradual (chronic) or abrupt (acute) and on the severity of red cell break down. Haemolytic anaemias may be due to a large number of hereditary or acquired causes, one of which is immune destruction of red cells when antibodies bind to red cells and lead to their breakdown. Acute haemolysis may be due to autoimmune haemolytic anaemia (autoimmune diseases or drug-related or idiopathic), hemoglobinopathies, red cell enzymopathies, acquired platelet disorders, HUS, DIC etc. This group of disorders may be associated with autoimmune diseases like rheumatoid arthritis, ulcerative colitis, systemic lupus erythematosus etc., certain malignant diseases like lymphomas and leukemias. In nearly 50% of cases, no cause may be found. The treatment depends on the underlying cause.