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Autoimmune Hemolytic Anemia (AIHA)

What is autoimmune hemolytic anemia?

Autoimmune hemolytic anemia (AIHA) occurs when the immune system mistakenly attacks red blood cells, causing their numbers to drop. There are two forms: warm antibody hemolytic anemia and cold antibody hemolytic anemia. 

What are the symptoms of autoimmune hemolytic anemia?

Symptoms may progress slowly or occur suddenly, and they include:

  • Jaundice
  • Tachycardia
  • Weakness
  • Fatigue
  • Breathing difficulties
  • Dark urine
  • Enlarged spleen

What causes autoimmune hemolytic anemia?

AIHA can occur as a primary condition or the result of another condition. In primary cases, the cause is unknown; medical professionals do not know why the immune system turns on red blood cells. In secondary cases, possible causes include:

  • HIV
  • Hepatitis
  • Chronic lymphocytic leukemia (CLL)
  • Epstein-Barr virus (EBV)
  • Autoimmune diseases like lupus
  • Non-Hodgkin’s lymphoma and other forms of blood cancer
  • Cytomegalovirus
  • Mycoplasma pneumonia

In rare cases, AIHA occurs after a blood and marrow stem cell transplant or the use of certain drugs, such as penicillin. 

How is autoimmune hemolytic anemia diagnosed?

If doctors suspect anemia, they will conduct a blood test to see the number of mature red blood cells versus immature ones. This will be followed by the Coombs test, which determines the number of antibodies in the blood. 

What are the treatments for autoimmune hemolytic anemia?

In secondary cases, doctors will work to treat the underlying condition. In primary cases, doctors will decide on a treatment course depending on severity. Mild cases may not require any treatment. As severity increases, intravenous hydrocortisone and oral steroids are used, followed by daily treatment with prednisone. If these are unsuccessful, doctors will try immunosuppressive drugs, removing the spleen, and blood transfusions. 

Where can I find out more about autoimmune hemolytic anemia?

AIHA Articles