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Alternative Names Return to topAnemia - immune hemolytic; Autoimmune hemolytic anemia (AIHA)
Definition Return to top
Immune hemolytic anemia is a condition in which there is a reduced blood cell count due to the premature destruction of red blood cells by the immune system.
Causes Return to top
Immune hemolytic anemia occurs when antibodies form against the body's own red blood cells. The antibodies will destroy the blood cells because the immune system mistakenly recognizes these blood cells as foreign material within the body. The antibodies may be caused by:
If the cause of antibody formation is disease or medication, it is referred to as secondary immune hemolytic anemia. If the cause is unknown, it is called idiopathic autoimmune hemolytic anemia. This type of anemia accounts for one-half of all immune hemolytic anemias.
Risk factors are related to the causes.
Symptoms Return to top
Exams and Tests Return to top
Treatment Return to top
Treatment with a steroid medication such as prednisone is usually the first therapy tried. If a steroid medication does not improve the condition, removal of the spleen (splenectomy) may be considered. Treatments with drugs that suppress the immune system (immunosuppressants) may also be given if you do not respond to steroids.
Blood transfusions, if needed for severe anemia, are given with caution because the blood may not be compatible and it may cause further hemolysis.
Outlook (Prognosis) Return to top
The disease may start quickly and be very serious, or it may remain mild and not need specific treatment.
In most people, steroids or splenectomy can control anemia. In others, treatment can usually partially control the anemia.
Possible Complications Return to top
Severe anemia rarely leads to death. Overwhelming infection may occur as a complication of treatment with steroids, other medications that suppress the immune system, or splenectomy, because these treatments reduce the body's ability to fight infection.
When to Contact a Medical Professional Return to top
Call your health care provider if you have unexplained fatigue or chest pain, or signs of infection.
Prevention Return to top
Screening for antibodies in donated blood and in the recipient may prevent hemolytic anemia related to blood transfusions.
References Return to topSchwartz RS. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 164. Update Date: 11/23/2008 Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.