Which condition is caused by either episodic or continuous premature destruction of erythrocytes?

• A. Thalassemia
• B. Hemolytic anemia
• C. Sickle cell disease
• D. Aplastic anemia

Answer: (B)

Premature destruction of erythrocytes means red blood cells are being cleared from the circulation faster than normal, so the body can’t keep up with production and anemia results. This is the defining feature of hemolytic anemia, where the problem is the loss of red cells due to their destruction, either episodically (as in autoimmune hemolysis when antibodies target cells in waves) or continuously (as in intrinsic red cell defects like membrane abnormalities or enzyme deficiencies, or from mechanical or microangiopathic causes). Aplastic anemia, by contrast, comes from the bone marrow failing to produce enough new cells, not from destruction. Thalassemia involves defective hemoglobin synthesis and ineffective erythropoiesis, while sickle cell disease centers on abnormal hemoglobin causing sickling and vaso-occlusion; red cell destruction occurs but the core issue is different from the premature destruction described here.