Ninehundred and thirty(our cases of the hemolytic anemia which were reported from
the depart-ments of internal medicine and pediatrics of 38 general hospitals and
university hospitals throughout the nation were summarized and reviewed. The data
collected comprised of the cases for 10 years from 1981 to 1990. The analysis was also
made according to the age groups ; adult and children. Isoimmune hemolytic anemia
was excluded in this study.
The following results were obtained.
1. Overall frequency showed increasing tendency beginning 1981 thru 1990.
2. Overall sex ratio of male to female was 1 : 1.2 without any significant sex
predominance. But ac-cording to the age groups, adult showed a definite female
predominance with the ratio of 1 : 1.6, while children showed slight predominance in
boys.
3. Age distribution showed even distribution in hemolytic anemias caused by intrinsic
red cell do-fects, u·utile definite predominance was shown in the fourth and the fifth
decades in cases of extrinsic red cell defects.
4. By etiological classfication, 315 cases were included In the Intrinsic category, 514
cases were in-rluded in the extrinsic category and 105 cases were unclassified.
5. Among intrinsic category, red cell mambrane disorders were 292 cases comprising
92.7%. One hundred and ninety-four cases among 292 were hereditary spherocytosis, 19
cases were hereditary elliptocytosis and 71 cases were paroxysmal nocturnal
hemoglobinuria.
6. In the disorders of hemoglobin, 2 cases of β-thalassemia minor and 6 cases of
proven G-6-PD deficiency were reported, which had been thought not to be present in
Korea before.
7. In extrinsic red cell defects category, there noted 169 cases (32.9%) of autoimmune
hemolytic anemia, 114 cases(22.2%) of traumatic or microangiopathic hemolytic anemia,
88(17.1%) cases of drug induced hemolytic anemia, 70 cases (13.6%) with collagen
vascular disease and 49 cases (9.5%) with infections.
8. In autoimmune hemolytic anemias, IgG warm antibodies were 1.8 times more
prevalent than IsM cold antibodies.
9. In hemolytic anemias associated with collagen vascuar diseases, systemic lupus
erythematosus was the most common disease(75%) followed by rheumatoid arthritis,
chronic active hepatitis and thyroid disease.
10. In hemolytic anemias associated with malignancies, there noted 7 cases with acute
leukemia, 4 cases with non Hodgkin's Iymphoma and 13 other cancers.
11. In drug induced hemolytic anemias, DDS was the most common agent comprising
41 cases among 85 cases followed by antibiotics(15 cases) and lead (13 cases).
12. In traumatic or microangiopathic hemolytlc anemia, the most frequent cause was
hemolytic ure-mic syndrome (34 cases) followed by DIC(32 cases) and cardiac hemolytic
anemia (15 cases).
13. The positive family history were present in 23 cases(11.9%) among 194 cases of
hereditary spherocytosis and 4 cases among 19 here ditary elliptocytosis.
14. Chief complaints on admission showed some differences between age groups, In
adult, they were subjective symptoms such as fatigue, pallor, jaundice, dizziness,
dyspnea, splenomegaly, headache, fever and so on, while in children they were objective
signs such as pallor, jaundice, fever, splenomegly, hepatomegaly and so on.
15. In 105 cases out of 934 cases, the cause of the hemolytic anemia were not
determined. More de-tailed laboratory workups were desired to clarify the causes.
16. Not all the departments, especially surgical parts, participated in this study.
Further extensive survey including all cases should be carried out to have more desired
statistics on the hemolytic ane-mia in Korea.
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