{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T14:54:02Z","timestamp":1793026442635,"version":"4.5.0"},"reference-count":28,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Sickle cell disease (SCD) is a prevalent genetic disorder caused by a mutation in the beta-globin gene. Hyperhemolysis (HS) is a severe complication involving the rapid destruction of both transfused and endogenous red blood cells, commonly found in SCD. This literature review explores the clinical presentation, diagnosis, pathogenesis, and management of HS in SCD. HS can manifest acutely or in a delayed manner, complicating diagnosis due to overlapping symptoms and varying reticulocyte responses. Immunohematological assessments often reveal delayed positivity in direct antiglobulin tests and antibody screens. HS typically presents severe anemia, jaundice, hemoglobinuria, and hemodynamic instability. Diagnostic markers include elevated bilirubin and lactate dehydrogenase levels alongside a reduced reticulocyte count. The management of HS is primarily empirical, with no clinical trials to support standardized treatment protocols. First-line treatments involve steroids and intravenous immunoglobulins (IVIG), which modulate immune responses and mitigate hemolysis. Refractory cases may require additional agents such as rituximab, eculizumab, tocilizumab, and, in some instances, plasma exchange or erythropoietin-stimulating agents. Novel therapeutic approaches, including bortezomib and Hemopure, have shown promise but require further investigation. Current management strategies are empirical, underscoring the need for robust clinical trials to establish effective treatment protocols that ultimately improve outcomes for SCD patients experiencing HS.<\/jats:p>","DOI":"10.3390\/diagnostics15141835","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T17:27:36Z","timestamp":1753118856000},"page":"1835","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Navigating Hyperhemolysis in Sickle Cell Disease: Insights from Literature"],"prefix":"10.3390","volume":"15","author":[{"given":"Sruthi","family":"Vellanki","sequence":"first","affiliation":[{"name":"Division of Hematology-Oncology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishanth","family":"Thalambedu","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anup Kumar Trikannad Ashwini","family":"Kumar","sequence":"additional","affiliation":[{"name":"Division of Myeloma, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sravya","family":"Vellanki","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, Willis Knighton Health System, Shreveport, LA 71103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Medhavi","family":"Honhar","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology Oncology, Arkansas Children\u2019s Hospital, Little Rock, AR 72205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Hendrix","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denese","family":"Harris","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamatha","family":"Gaddam","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunny R. K.","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivi","family":"Jain","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology, and Cell Therapy, Rush University Medical Center, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muthu","family":"Kumaran","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesar","family":"Gentille","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankur","family":"Varma","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1111\/bjh.13494","article-title":"How we treat delayed haemolytic transfusion reactions in patients with sickle cell disease","volume":"170","author":"Gardner","year":"2015","journal-title":"Br. 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