Autoimmune hemolytic anemia (patient information)
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Autoimmune hemolytic anemia |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Autoimmune hemolytic anemia occurs when antibodies form against the body's own red blood cells and destroy them. This happens because the immune system mistakenly recognizes these blood cells as foreign.
What are the symptoms of Autoimmune hemolytic anemia?
You may not have symptoms if the anemia is mild. If the problem develops slowly, symptoms that may occur first include:
- Feeling grumpy
- Feeling weak or tired more often than usual, or with exercise
- Headaches
- Problems concentrating or thinking
If the anemia gets worse, symptoms may include:
- Blue color to the whites of the eyes
- Brittle nails
- Light-headedness when you stand up
- Pale skin color (pallor)
- Shortness of breath
- Sore tongue
What causes Autoimmune hemolytic anemia?
Possible causes include:
- Certain chemicals, drugs, and toxins
- Infections
- Transfusion of blood from a donor with a blood type that does not match
- Certain cancers
When antibodies form against red blood cells for no reason, the condition is called idiopathic autoimmune hemolytic anemia.
The antibodies may also be caused by:
- Complication of another disease
- Past blood transfusions
- Pregnancy (if the baby's blood type is different from the mother's)
Risk factors are related to the causes.
When to seek urgent medical care?
Call your health care provider if you have unexplained fatigue or chest pain, or signs of infection.
Diagnosis
- Absolute reticulocyte count
- Direct or indirect Coombs' test
- Hemoglobin in the urine
- LDH (level of this enzyme rises as a result of tissue damage)
- Red blood cell count (RBC), hemoglobin, and hematocrit
- Serum bilirubin levels
- Serum free hemoglobin
- Serum haptoglobin
Treatment options
The first treatment tried is usually a steroid medication, such as prednisone. If steroid medications do not improve the condition, treatment with intravenous immunoglobulin (IVIG) or removal of the spleen (splenectomy) may be considered.
You may receive treatment to suppress your immune system if you do not respond to steroids and splenectomy. Medications such as azathioprine (Imuran), cyclophosphamide (Cytoxan), and rituximab (Rituxan) have been used.
Blood transfusions are given with caution, because the blood may not be compatible and it may cause more red blood cell destruction.