If your child has been diagnosed with pediatric hemolytic anemia, you might wonder just what this condition is and what caused it. The short answer: Hemolytic anemia is a blood disorder that occurs when red blood cells (RBCs) break down faster than the body makes them.

But the exact reason someone develops hemolytic anemia depends on a number of factors, and your child’s particular case could stem from one or more possible causes. Sometimes, gene-related problems that are present at birth lead to the production of abnormal red blood cells, which the body destroys. Children also may come down with an infection or a condition that damages red blood cells or causes the body to mistake healthy RBCs for unhealthy ones, breaking them down prematurely.

Several inherited blood disorders or conditions developed later may lead to hemolytic anemia in children, and some causes may overlap. Read on to learn more about five possible causes of and risk factors of pediatric hemolytic anemia.

1. Some Inherited Disorders Affect Red Blood Cells

Inherited blood disorders can affect how red blood cells are made in the bone marrow, how they’re shaped, or how they work, factors that can weaken RBCs. Blood disorders that run in families and may contribute to hemolytic anemia include:

• Sickle cell anemia — Changes RBCs’ shape to crescents that resemble sickles
• Pyruvate kinase deficiency — Causes RBCs to break down unusually fast
• Glucose-6-phosphate dehydrogenase (G6PD) deficiency — Leads to lack of an enzyme that RBCs need to work properly
• Thalassemia — Hinders production of healthy RBCs
• Paroxysmal nocturnal hemoglobinuria — Results in RBC damage by the immune system
• Hereditary spherocytosis — Causes fragile, sphere-shaped RBCs

Your body can tell whether red blood cells are healthy and working properly and will quickly get rid of those that are unhealthy. If all of a child’s RBCs are unhealthy, this process results in lower-than-normal levels of RBCs and pediatric hemolytic anemia.

2. An Overactive Spleen May Destroy Too Many Red Blood Cells

Hypersplenism is when the spleen, an organ that filters and stores blood, becomes too large and removes too many RBCs from the blood. The spleen can get enlarged from certain infections and in liver disease and cancer. Inherited metabolic conditions such as sickle cell disease can also lead to hypersplenism and the destruction of red blood cells. In some cases, splenectomy (surgical removal of the spleen) may be recommended.

3. Infections Can Damage Healthy Red Blood Cells

During infection, pathogens (causes of disease) such as viruses, bacteria, and parasites can break down or damage healthy red blood cells. Infections associated with hemolytic anemia include mononucleosis, Haemophilus influenzae (some types of ear, eye, and sinus infections and pneumonia), Rocky Mountain spotted fever, and malaria.

4. Certain Medications Can Lead to Hemolytic Anemia

If your child has G6PD deficiency, their red blood cells may be sensitive to certain drugs, including:

• Sulfonamides (antibiotics with “sulfa” in their name)
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Antimalarial drugs

These medications can trigger a hemolytic crisis — fast but brief loss of RBCs — but sometimes lead to chronic (long-lasting) anemia.

5. A Faulty Immune System May Attack Red Blood Cells

When RBCs are damaged, the body must remove them from the blood. But sometimes, the immune system starts to erroneously identify healthy red blood cells as unhealthy and destroys them. This leads to an autoimmune disease — a condition caused by a misguided immune system — called autoimmune hemolytic anemia (AIHA). Only about 8 in a million people under 18 are diagnosed with this rare disease.

In AIHA, the immune system produces antibodies (immune proteins) that attack RBCs. Other autoimmune disorders — such as lupus, rheumatoid arthritis, and ulcerative colitis — can also affect the body’s production and breakdown of red blood cells.

Work With Your Child’s Doctor

Pediatric hemolytic anemia can be a serious condition, but it can be managed with proper treatment. If your child has been diagnosed with hemolytic anemia, it’s important to work closely with their health care provider to identify the underlying cause and develop a treatment plan. Following their health care provider’s recommendations is the best way to help your child manage hemolytic anemia.

By understanding the possible causes of pediatric hemolytic anemia, you can be better prepared to help your child manage the condition and stay healthy.

Talk With Others Who Understand

On myAIHAteam, the social network for people with hemolytic anemia and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with hemolytic anemia.

Has your child been diagnosed with hemolytic anemia? Did you talk with your child’s health care provider about its cause? Share your experience in the comments below, or start a conversation by posting on your Activities page.