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Autoimmune Hemolytic Anemia: Treatment, Symptoms & Types

autoimmune anemias

Autoimmune hemolytic anemia, or AIHA, is a rare blood condition characterized by a red blood cell count decline. Autoimmune anemias are caused by the production of antibodies that target red blood cells (RBCs). As a result, the RBC count decreases. Symptoms may include excessive fatigue and weakness, rapid heart rate, difficulty breathing, jaundice, dark urine, and spleen enlargement. AIHA may have no known cause (primary or idiopathic) or be a side effect of another disease or treatment.

The present article sheds light on various aspects of autoimmune anemias. It highlights warm hemolytic anemia. Moreover, the article also discusses the autoimmune hemolytic anemia prognosis and explores its symptoms and available treatment options. So, continue reading to gain in-depth knowledge related to autoimmune anemias.

Autoimmune Anemias

Autoimmune anemias, a group of rare disorders, involve hemolysis, i.e., rapid RBC destruction. Idiopathic-acquired autoimmune anemias result when the immune system mistakenly attacks and harms healthy tissues. In a healthy individual, erythrocytes (RBCs) exist for around 120 days before being eliminated by the spleen. The severity of this type of anemia depends on two factors: the average lifespan of RBCs and the rate at which bone marrow replenishes them.

Types of Autoimmune Hemolytic Anemia

If anemia develops in conjunction with another health issue, it is referred to as “secondary” anemia because it is related to the other issue. The most common forms of acquired autoimmune hemolytic anemia are:

  • Warm antibody anemia
  • Cold antibody anemia

Cold and Warm Hemolytic Anemia

In warm hemolytic anemia, autoantibodies attach to red blood cells. The attachment initiates cell destruction when the body’s temperature rises above normal.

Autoantibodies bind to RBCs in cold hemolytic anemia. The antibodies kill these cells at temperatures below the normal body temperature.

Warm hemolytic anemia is caused by IgG antibodies binding to RBCs. Typically, symptoms develop gradually for weeks. In certain instances, they can occur within a few days. On the other hand, IgM autoantibodies are responsible for cold hemolytic anemia. RBCs clump together when your blood temperature is lower than the core body temperature.

Autoimmune Hemolytic Anemia Prognosis

Inherited hemolytic anemia is caused by the genes that pass from parents to their children. Sickle cell anemia and thalassemia are the most common types of inherited anemia. Due to these conditions, the RBCs produced have a shorter lifespan than normal RBCs.

Acquired hemolytic anemia has various causes. Some of the factors that are associated with this type of anemia include:

  • Viral or bacterial infections
  • Blood cancer
  • Certain medicines
  • Autoimmune disorders
  • Hypersplenism, i.e., overactive spleen
  • Immune reaction to blood transfusion

Certain types of acquired hemolytic anemia resolve independently after a few months. Some could last your entire lifetime. They may vanish for a time and return later.

Autoimmune Specialist

Symptoms of Autoimmune Hemolytic Anemia

The symptoms can be different for each individual. Among the possible symptoms are the following:

  • Abnormal paleness
  • Jaundice (yellowish skin and eyes)
  • Dark-colored urine
  • Fever
  • Breathlessness
  • Fatigue
  • Dizziness
  • Enlarged liver or spleen
  • Tachycardia (increased heart rate)
  • Heart murmur

The symptoms of hemolytic anemia could be mistaken for those of other blood diseases or health issues. Hence, consulting your primary care physician for an accurate diagnosis is crucial.

Autoimmune Hemolytic Anemia Diagnosis

The diagnosis involves a complete blood count (CBC test) to examine the blood. CBC indicates the number of RBCs and the amount of hemoglobin in the blood.

Additional tests may also be conducted if the CBC reveals anemia, characterized by a low number of red blood cells and a low hemoglobin level.

These modalities include:

  • Bilirubin and lactate dehydrogenase (LDH):  This test searches for indicators of red blood cell breakdown in the body. Destruction of RBCs leads to an excessive amount of LDH and bilirubin.
  • Microscopic Examination: It involves examining the blood film under a microscope for changes in the form of the RBCs.
  • DAT (Coombs Test): The Direct Antiglobulin Test (DCT) reveals whether or not your red blood cells are covered with antibodies, an indication of AIHA.

In the majority of cases of AIHA, no underlying illness is present. To rule out the chance of a secondary condition, your physician may conduct additional tests, such as a CT body scan or bone marrow biopsy. To detect infections, you may be required to undergo further blood tests.

Autoimmune Hemolytic Anemia Treatment

Autoimmune anemias can be treated with a variety of therapeutic approaches.

If you have AIHA, your doctor will determine the appropriate treatment based on the severity of your symptoms, general health, and whether you have primary or secondary AIHA.

If your AIHA has a secondary origin, such as an infection or cancer, your doctor may advise you to treat the underlying condition first. If your physician believes that a particular medication is the cause of your AIHA, you may need to switch to a different medication.

Steroids

Most AIHA patients are given steroid medications. By suppressing the immune system, these medications cut down the rate at which the RBCs are destroyed. Since corticosteroids are an effective treatment for AIHA, most patients only need to take them briefly.

Splenectomy

Splenectomy is the process in which the spleen is removed surgically. As the spleen is responsible for most RBC loss, splenectomy is one treatment option for AIHA. A splenectomy is performed as part of an operation while the patient is under general anesthesia. The surgery is performed laparoscopically, requiring very few skin incisions. After this type of surgery, the patient should be able to recover rapidly and only requires a brief hospital stay.

Intravenous Immunoglobulin

IVIG is a pharmaceutical product that comprises antibodies. Immunoglobulins are produced by white blood cells to fight infections. Immunoglobulins are derived from humans, which necessitates the usage of a substantial amount of blood. A drip is inserted into a vein before administering this medication. It is administered as a liquid through the veins.

Immunosuppressants

Autoimmune anemias may also be treated with a variety of other immune-suppressing medications. These medications reduce the number of white blood cells in the body.

See Also: Symptoms Of Autoimmune Connective Tissue Diseases

Conclusion

The destruction of red blood cells characterizes autoimmune anemias. Autoimmune hemolytic anemia can be inherited or acquired. There is a transmission of the gene responsible for the condition in the inherited type of autoimmune anemia. The acquired type of autoimmune anemia does not involve genetic transmission; instead, it results from causes like infection or other autoimmune disorders. Blood transfusions, corticosteroids, and several other medications treat this illness. Autoimmune hemolytic anemia causes weakness, pallor, jaundice, fever, dark-colored urine, difficulty performing strenuous work, and a heart murmur. You should consult immediate medical assistance if you experience any of these symptoms.

Autoimmune specialists at Family Medicine Austin are here for your assistance with their extensive knowledge to address your specific needs. We will assist you in regaining control of your life so that it can once again be full and interesting with our cutting-edge techniques and holistic strategy,

Do you want to know how your autoimmune disease can be diagnosed and treated? Please schedule an appointment with one of our autoimmune specialists.

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Written by Jeannette

I am Jeannette, the medical writing specialist here at Family Medicine Austin. I have over five years of experience working with a range of medical and healthcare across the U.S.