Autoimmune hemolytic anemia causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Assosciate Editor(s)-In-Chief: Prashanth Saddala M.B.B.S; Shyam Patel [2]
Overview
Causes
Primary autoimmune hemolytic anemia
- Infections: Infections such as Mycoplasma can cause autoimmune hemolytic anemia.
Secondary autoimmune hemolytic anemia
Secondary autoimmune hemolytic anemia is due to an underlying condition, such as malignancy or autoimmune disorders.
- Malignancy: Blood-related cancers accounts for 50% of cases of secondary autoimmune hemolytic anemia. A variety of malignancies can cause secondary warm autoimmune hemolytic anemia including chronic lymphocytic leukemia (CLL) and non-Hodgkin's lymphoma.[1] Lymphoproliferative disorders are more commonly associated with secondary autoimmune hemolytic anemia compared to myeloproliferative disorders. The premise behind lymphoproliferative disorders causing secondary autoimmune hemolytic anemia is that these conditions cause abnormal immune activation which results in plasma cells producing antibodies, which can then attack normal red blood cells.
- Chronic lymphocytic leukemia (CLL): Approximately 10-25% of patients with CLL will develop autoimmune hemolytic anemia [1] The presence of autoimmune hemolytic anemia in patients with CLL is an indication for treatment of CLL and suggests a worse prognosis compared to the absence of autoimmune hemolytic anemia. In CLL, the malignant B lymphocytes are not the cells that produce anti-red blood cell antibodies.[2]
- Non-Hodgkin's lymphoma (NHL): This condition is less commonly associated with autoimmune hemolytic anemia compared to CLL. A variety of NHLs can result in autoimmune hemolytic anemia.
- Autoimmune disorders[3] : Systemic autoimmune conditions can also cause secondary autoimmune hemolytic anemia. The premise behind autoimmune conditions causing secondary autoimmune hemolytic anemia is failure of self-recognition by the immune system, resulting in aberrant immune activation and production of autoantibodies that attack normal cells, including red blood cells.[3] These conditions include:
- Systemic lupus erythematosus (SLE): One of the 11 diagnostic criteria for SLE is hematologic abnormalities such as cytopenias.
- Hypothyroidism
- Sjogren's syndrome
- Primary biliary cirrhosis
- Primary hypogammaglobulinemia
- Inflammatory bowel disease
- Medications
- Infections
References
- ↑ 1.0 1.1 Berentsen S, Sundic T (2015). "Red blood cell destruction in autoimmune hemolytic anemia: role of complement and potential new targets for therapy". Biomed Res Int. 2015: 363278. doi:10.1155/2015/363278. PMC 4326213. PMID 25705656.
- ↑ Tandra P, Krishnamurthy J, Bhatt VR, Newman K, Armitage JO, Akhtari M (2013). "Autoimmune cytopenias in chronic lymphocytic leukemia, facts and myths". Mediterr J Hematol Infect Dis. 5 (1): e2013068. doi:10.4084/MJHID.2013.068. PMC 3867225. PMID 24363883.
- ↑ 3.0 3.1 Berentsen S (2015). "Role of Complement in Autoimmune Hemolytic Anemia". Transfus Med Hemother. 42 (5): 303–10. doi:10.1159/000438964. PMC 4678321. PMID 26696798.