Jaundice refers to a yellowish color of the skin or whites of the eyes. When red blood cells die, they release hemoglobin into the bloodstream. The hemoglobin is broken down into a compound called bilirubin, which gives the skin and eyes a yellowish color. Bilirubin also causes urine to be dark yellow or brown. Severe Reaction to a Blood Transfusion. You may develop hemolytic anemia due to a blood transfusion. This can happen if the transfused blood is a different blood type than your blood. Signs and symptoms of a severe reaction to a transfusion include fever, chills, low blood pressure, and shock.