The main symptoms of hemolysis are:
- Hemoglobinuria and icterus (Aulbert 2008).
In acute hemolysis may occur:
- Tachycardia
- palpitations
- exertional dyspnea (Berger 2010).
In chronic hemolysis, there are usually hardly any symptoms. Even hemoglobin levels up to 6 - 8 mg / dl are tolerated. Otherwise there may be:
- low-grade icterus
- splenomegaly (Berger 2010)
- Palpitations during exertion (Kasper 2015)
- tendency to thrombosis
-occurrence of pigment gallstones
- General symptoms of anemia such as reduction in performance, fatigue, dizziness, dyspnea on exertion (Herold 2022).
In hemolytic crisis, an acute emergency situation, may additionally occur:
- collapse
- Icterus with hyperbilirubinemia; typical for hemolysis are a strongly elevated indirect bilirubin and a normal direct bilirubin (Herold 2022)
- rapid Hb drop
- hemoglobinuria (Herold 2022)
- chills
- fever
- pain in the back, abdomen, head (Berger 2010)
In intravascular hemolysis, in which there is a rapid release of free hemoglobin, acute back pain, hemoglobinuria with appearance of free hemoglobin in the urine, and possible onset of renal failure are often found (Kasper 2015).