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Patient education: Autoimmune hemolytic anemia (The Basics)

Patient education: Autoimmune hemolytic anemia (The Basics)

What is autoimmune hemolytic anemia? — Autoimmune hemolytic anemia is a type of hemolytic anemia. Anemia is the medical term for when a person has too few red blood cells. Red blood cells are the cells in your blood that carry oxygen. If you have too few red blood cells, your body might not get all the oxygen it needs. "Hemolytic" anemia is anemia that happens when red blood cells are destroyed. In other types of anemia, the body might not make enough red blood cells.

Autoimmune hemolytic anemia happens because the body's infection-fighting system, called the "immune system," destroys red blood cells. Normally, the immune system kills germs. If the immune system starts to attack healthy cells, this is called an "autoimmune" response. If your immune system attacks and destroys your red blood cells, you get autoimmune hemolytic anemia.

What causes autoimmune hemolytic anemia? — In many cases, there is no specific cause, and it just happens. But sometimes, it is related to:

Infections such as pneumonia and mononucleosis (also called "mono")

Certain types of cancer, including chronic lymphocytic leukemia (CLL), multiple myeloma, and lymphoma. Lymphoma is a type of cancer that affects cells of the immune system.

Autoimmune diseases such as lupus – In people with lupus, the immune system can attack cells and organs all over the body.

Certain medicines, including some antibiotics

Most of the time, these things do not cause autoimmune hemolytic anemia.

What are the symptoms of autoimmune hemolytic anemia? — Symptoms are the same as in other types of anemia. They might include:

Pale skin or a pale color in the tissue that lines the inside of the eyelids – You can see this tissue (called "conjunctiva") by gently pulling down your lower eyelid. The tissue will appear pale instead of its normal, pinkish-red color.

Feeling very tired

A fast heartbeat

Trouble breathing

Headache and muscle pains

Some types of autoimmune hemolytic anemia cause other symptoms, such as reddish or brown urine

Is there a test for autoimmune hemolytic anemia? — Yes. There are blood tests for anemia. Then, if the cause cannot be found, doctors use blood tests to check for autoimmune hemolytic anemia. The most important one is called the direct antiglobulin test (also called the DAT or "Coombs test"). This test checks for signs of an immune system attack on your red blood cells.

There are other tests that tell if your red blood cells are being destroyed.

How is autoimmune hemolytic anemia treated? — Treatments can include:

Medicines that make your body's immune system less active, such as steroids (prednisone or solumedrol) – This is usually the first thing doctors try.

Other medicines, such as cyclophosphamide (brand name: Cytoxan) or rituximab (brand name: Rituxan), if the steroid is not working well

If the autoimmune hemolytic anemia is due to a condition like CLL or lupus, treatment of that condition might also treat the anemia

If the anemia is very severe, it might be treated with blood transfusions.

In some cases, your doctor might suggest surgery to remove an organ called the spleen. The spleen is where the immune system destroys red blood cells. This surgery is called "splenectomy." Your doctor can talk to you about the risks and benefits of this surgery.

More on this topic

Patient education: Oral steroid medicines (The Basics)
Patient education: Splenectomy (The Basics)
Patient education: Intravenous immune globulin (IVIG) (The Basics)

This topic retrieved from UpToDate on: Feb 02, 2024.
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