What causes hemolysis in children?

Many people may not know what hemolysis means. In fact, it is very easy to understand. Hemolysis refers to the rupture of red blood cells in human blood. Once the red blood cells rupture, the hemoglobin inside will overflow, so it is also called red blood cell solution. There are many reasons for hemolysis in the human body. For example, some infants and young children may suffer from hemolysis due to genetic factors.

What causes hemolysis in children?

1. Jaundice appears within 24 hours after birth and rapidly worsens.

2. Severe jaundice develops from the face, neck, sclera to the trunk, limbs, and palms and soles.

3. The skin gradually changes from light yellow to golden yellow. When accompanied by anemia, it may become pale yellow and edema may occur.

4. Laboratory tests showed symptoms of jaundice and hemolytic anemia: significantly increased indirect bilirubin, low hemoglobin, increased reticulocytes; and incompatibility of blood types between mother and child.

5. Confirmation also requires some special tests on the blood of the mother and child, such as the mother-child cross-immunity test (Comb test). It has been observed in medical practice that not all children whose mothers and children have incompatible blood types will develop hemolytic disease. Only a small number of them will develop the disease and the severity of the disease can vary greatly. In mild cases, the clinical manifestations are similar to physiological jaundice; in severe cases, the condition is very serious and may be life-threatening if diagnosis and treatment are delayed. Why this difference occurs is not particularly clear at present.

Generally speaking, the symptoms of Rh hemolysis appear earlier and are more severe than those of ABO hemolysis. Rh hemolysis usually occurs in the second pregnancy, while ABO hemolysis may occur in the first pregnancy. Hemolytic disease of the newborn is closely related to genetic factors, so the fetus of a subsequent pregnancy is more likely to develop the disease and the symptoms will be more severe.

Causes of hemolysis:

It can be caused by a variety of physical and chemical factors and toxins. In vitro, hypotonic solutions, strong mechanical shaking, sudden low-temperature freezing (-20℃～-25℃) or sudden thawing, excessive acidity or alkali, as well as alcohol, ether, saponin, bile salts, etc. can all cause hemolysis.

The isotonic solution of human plasma is 0.9% NaCl solution. When red blood cells are in a solution with a concentration of less than 0.45% NaCl, water infiltrates into the red blood cells, causing them to swell and rupture, and hemoglobin escapes. In the body, hemolysis can be caused by invasion of hemolytic bacteria or certain snake venoms, antigen-antibody reactions (such as transfusion of incompatible blood), various mechanical injuries, intrinsic red blood cell (membrane, enzyme) defects, certain drugs, etc. Hemolytic bacteria, such as some hemolytic streptococci and Clostridium perfringens, can cause sepsis. Malaria parasites destroy red blood cells and some hemolytic snake venoms contain lecithinase, which converts the lecithin in plasma or red blood cells into lysophosphatidylcholine, causing the red blood cell membrane to decompose.