How should I monitor a patient with chronic haemolytic anaemia for potential complications?

Monitoring a patient with chronic haemolytic anaemia for potential complications involves regular clinical and laboratory assessments focused on early detection of organ damage, iron overload, and associated metabolic disturbances.

Regular full blood counts and reticulocyte counts are essential to assess ongoing haemolysis and bone marrow response, while liver function tests and serum bilirubin help monitor haemolysis severity and hepatic involvement ¹.

Because chronic haemolysis can lead to iron overload, particularly in patients receiving transfusions, serum ferritin and transferrin saturation should be measured periodically to guide iron chelation therapy and prevent organ toxicity (Saliba et al., 2016).

Renal function should be monitored closely with serum creatinine, estimated glomerular filtration rate (eGFR), and urinalysis to detect early signs of chronic kidney disease, which is a recognized complication of chronic haemolysis ¹.

Vitamin B12 and folate levels should be checked to exclude or treat nutritional deficiencies that may exacerbate anaemia ¹.

Regular assessment for complications such as gallstones, leg ulcers, and pulmonary hypertension is recommended through clinical examination and appropriate imaging or specialist referral as indicated ¹.

In patients on iron chelation therapy, monitoring for therapy-related adverse effects including hepatic, cardiac, and endocrine dysfunction is critical, with periodic MRI assessments of liver and cardiac iron load advised (Saliba et al., 2016).

In summary, a comprehensive monitoring plan for chronic haemolytic anaemia includes hematological parameters, iron studies, renal and liver function tests, nutritional assessments, and surveillance for organ-specific complications to enable timely intervention and reduce morbidity.