Mechanical hemolytic anemia

Cause

Repetitive impacts to the body may cause mechanical trauma and bursting (hemolysis) of red blood cells. This has been documented to have occurred in the feet during running and hands from Conga or Candombe drumming. Defects in red blood cell membrane proteins have been identified in some of these patients. Free hemoglobin is released from lysed red blood cells and filtered into the urine.

Hemolytic phenomena

March hemoglobinuria

March hemoglobinuria, occurs when hemoglobin is seen in the urine after repetitive impacts on the body, particularly affecting the feet. The word "march" is in reference to the condition arising in soldiers who have been marching for long periods; the condition was first documented in 1881.

Runner's macrocytosis

Runner's macrocytosis is a phenomenon of increased red blood cell size as a compensatory mechanism for increased red blood cell turnover. The impact forces from running can lead to red blood cell hemolysis and accelerate red blood cell production. This can shift the ratio of red blood cells towards younger, larger cells. This shift may be reflected in higher than normal mean corpuscular volume (MCV) values, an indicator of red blood cell size.

This is not a pathological condition but may indicate a propensity toward iron deficiency anemia due to high red blood cell turnover.

References

References

1. Dan L. Longo, ''Harrison's Hematology and Oncology'', 2010, {{ISBN. 0-07-166335-5; page 121.
2. Reinhold Munker, Erhard Hiller, Jonathan Glass, Ronald Paquette, ''Modern Hematology: Biology and Clinical Management'', 2007, page 126, {{ISBN. 1-58829-557-5.
3. Anthony S. Fauci, Eugene Braunwald, Dennis Kasper, Stephen Hauser, Dan L. Longo, ''Harrison's Manual of Medicine'', page 328, 2009, {{ISBN. 0-07-147743-8.
4. (2008). "Rust Urine after Intense Hand Drumming Is Caused by Extracorpuscular Hemolysis". Clinical Journal of the American Society of Nephrology.
5. (November 1979). "An erythrocyte membrane-protein anomaly in march haemoglobinuria". Lancet.
6. (September 1941). "MARCH HEMOGLOBINURIA: Studies of the Clinical Characteristics, Blood Metabolism and Mechanism: with Observations on Three New Cases, and Review of Literature". Medicine.