Footstrike Hemolysis (March Hemoglobinuria)

Description

Footstrike hemolysis is a condition seen most often in distance runners. It is characterized by the breakdown of red blood cells in blood vessels, which is related to multiple factors: the hardness of a running surface, elevated body temperature, and increased fragility of older red blood cells. In most cases the effect of the red blood cell destruction is mild and does not result in anemia, iron deficiency, or hematuria. The diagnosis is usually made by measuring the serum haptoglobin level or by demonstrating that hemoglobin is present in the urine within hours to days after intense exercise.

Common signs and symptoms

• Usually, no signs or symptoms

• Iron deficiency anemia, a decrease in red blood cells from lack of iron

• Hemoglobinuria (hemoglobin in urine)

• Reticulocytosis (increased reticulocyte count)

• Fewer red blood cells because of blood cell destruction (hemolytic anemia)

Causes

• Hard running surfaces

• Worn-out running shoes

• Inherited abnormalities of red blood cells (hereditary spherocytosis)

Factors that increase risk

• Worn-out running shoes

• Hard running surfaces

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