Ribavirin hemolysis
Common Questions and Answers about Ribavirin hemolysis
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The most frequent side effect of ribavirin is hemolytic anemia, which occurs in up to one-third of patients. Ribavirin causes hemolysis because ribavirin triphosphate is concentrated by erythrocytes. ..... During treatment with ribavirin, bilirubin and uric acid levels increase in about 10%–25% of patients. These side effects disappear 4–7 weeks after discontinuation of therapy."
http://www.annalsofhepatology.com/old/PDF/vol5s1/Hp06S1-19.
If you were having hemolysis I think you would see either a low-normal hemoglobin or a low hemoglobin depending on the rate of hemolysis. To test for hemolysis a Haptoglobin and Reticulocyte tests would probably be appropriate.
I don't know enough about Gilbert's Syndrome to have any idea how elevated the indirect bilirubin generally is. This disorder is considered to be benign without any ill affects.
The ribavirin is what is causing your aunt's anemia, no food or supplements are going to help, as said above you need to talk to your aunt's doc and come up with a plan, which will either be lowering her riba dosage or administering rescue drugs, at 8.5 it really needs to be dealt with ASAP
What is Hemolytic Anemia?
Your bone marrow is responsible for producing red blood cells, white blood cells, and platelets (cells responsible for clotting).
Ribavirin is renally excreted, and if there is impaired renal function, ribavirin blood levels are higher and hemolysis is greater. This is a population in which viramidine might be of some use. If creatinine levels are greater than 2 times the upper limit of normal, ribavirin is generally not used. A reduced dose of ribavirin has been used in some patients with creatinine levels less than 2 times the upper limit of normal.
If it was a low grade hemolysis I would expect to see low hemoglobin and/or red blood cell count?
Generally when you're looking at a possible hemolytic anemia a haptoglobin test and a reticulocyte count are ordered.
On all of the lab reference ranges I have seen have a total bilirubin of 2.7 would be elevated but since you're in India I have no idea about the ranges there.
I would ask whether a fractionalized bilirubin test might be appropriate.
The depletion in red cells can be managed either by taking a hormone supplement (procrit/epoetin) or by reducing the ribavirin dose.If your viral load is undetectable this can be safely done.
Similarly the white cells can be artificially boosted,or the dose of interferon reduced.Reducing or skipping interferon is not desirable.
Iron tablets are not really the issue here.
the abnormal liver tests associated with hepatitis A can persist for many weeks some times. rarely hemolysis can also be seen, which could account for indirect hyperbilirubinemia.
Hi,
Raised liver enzymes in a G6PD baby with pale palms does raise the suspicion of hemolysis. A raised LDH (lactate dehydrogenase) and a low level of haptoglobin will help in diagnosing hemolysis. I would suggest you to please discuss this with your child’s pediatrician and get these tests done as soon as possible.
I'm on ribavirin. I have read on here that lower red cell is a good thing. I've boosted my b-12 dosage, meat, egg yolk, bean, leafy green intake to help keep mine up. am I helping or hurting my recovery by trying to keep red cell count \ up?
even though you are not anemic the blood smear appears abnormal, suggesting maybe there is some mild hemolysis ongoing, leading to the elevated bilirubin level
It stands for 'hemolysis, elevated liver enzymes, and low platelets' it's a rare form of pre-eclampsia. But it's dangerous for mom and baby.
Nothing too out of the whack. Na, BUN, AST are all marginal, but nothing concerning. It would help if there was some clinical history behind this test.
When a dog eats onions, the sulfur compounds in the onion cause the Heinz bodies to rupture and release the hemoglobin. This rupturing of the red blood cells is known as hemolysis. The body then passes out the dead red blood cells in the urine, and the brown color that you see is those dead red blood cells.
As long as the hemolysis stops before too many red blood cells are destroyed, the body WILL rebuild its supply of red blood cells.
I think hemodialysis and its suppression of immune function is making the HCV disease progress. Ribavirin leads to severe hemolysis in people with a creatinine clearance of less than 20; mine is about 7. Although there have been no proper scientific trials yet because they are scared to enroll people in the riba arm; thinking it might be a bit unethical to risk their lives in the name of scientific inquiry. Also I am on transplant list and there is a real worry that 1.
Having jaundice with all liver tests normal + low iron, indicates hemolysis - a break down of red blood cells from some reason. Red blotches...are not normal. It may all be a side effect or allergy to synthroid. You should see the doctor promptly.
Liver enlargement or hepatomegaly could be due to liver disorders or due to systemic causes like heart failure or hemolysis. The cause for enlargement needs to determined. This is done with the help of blood tests, ultra sonogram and if need be, biopsy of liver will help to clinch the diagnosis. If you can get back to me with the diagnosis, I will be able to elaborate further.
Hope this helped and do keep us posted.
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