Microangiopathic hemolytic anemia as a complication of diabetes mellitus.
A mature-onset diabetic patient who developed microangiopathic hemolytic anemia (MHA) is presented. Although numerous causes of hemolysis are reported in the literature, MHA is a rare complication of diabetes. The proposed mechanism of hemolytic anemia is thought to be related to the abnormal formation of cell membranes in the diabetic environment. The ratio of cholesterol to phospholipid in the core of the membrane is altered in diabetics; as a result, the red blood cell wall becomes rigid and nondeformable. The abnormal cells becomes disrupted as they circulate through the microangiopathic blood vessels. The mechanism of action of the antiplatelet agents is to enhance cell membrane compliance. With improved cell-wall compliance, one can expect a reduction in hemolysis, as occurred in our patient. The literature on diabetes mellitus-related microangiopathic hemolytic anemia is reviewed.
James
S H
SH
University of the Witwatersrand, Johannesburg, South Africa.
Meyers
A M
AM
D000743:Anemia, Hemolytic / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D003928:Diabetic Nephropathies / Q000150:complications / Q000473:pathology; D004912:Erythrocytes / Q000473:pathology; D005296:Ferrous Compounds / Q000627:therapeutic use; D006400:Hematocrit; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010431:Pentoxifylline / Q000627:therapeutic use; D010976:Platelet Count; D014665:Vasodilator Agents / Q000627:therapeutic use
D005296:Ferrous Compounds; D007328:Insulin; D014665:Vasodilator Agents; C020748:ferrous sulfate; D010431:Pentoxifylline