Health Library

Autoimmune Hemolytic Anemia

Definition

Anemia is a low level of healthy red blood cells (RBC). RBCs carry oxygen from the lungs to the rest of the body. When red blood cells are low the body does not get enough oxygen. This can cause symptoms such as fatigue, pale skin, or irregular heartbeat.

Autoimmune hemolytic anemia is caused by the destruction of RBCs. It can be a serious, fatal condition that requires care from a doctor.

Red Blood Cells
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Causes

This type of anemia is caused by an autoimmune problem. The immune system attacks and destroys red blood cells. The abnormal reaction of the immune system may be caused by:

Risk Factors

Risk factors that increase your chance of developing autoimmune hemolytic anemia include:

  • Recent viral infections
  • Current medications that can cause autoimmune hemolytic anemia
  • Cancer or leukemia
  • Collagen-vascular (autoimmune) disease
  • Family history of hemolytic disease

Symptoms

If you experience any of these symptoms, do not assume the cause is due to autoimmune hemolytic anemia. These symptoms may be caused by many other health conditions.

  • Dark brown urine
  • Jaundice (yellow skin)
  • Pallor (pale skin)
  • Muscle pains
  • Headache
  • Nausea and vomiting
  • Diarrhea
  • Weakness
  • Shortness of breath
  • Rapid heartbeat

Diagnosis

Your doctor will ask about your symptoms, medications, and medical history. A physical exam will be done. You may be referred to a doctor who specializes in blood and blood-forming tissues (a hematologist).

Tests may include:

  • Blood tests
  • Urine tests

Treatment

Talk with your doctor about the best treatment plan for you. Mild cases may not need treatment. They may resolve on their own. Treatment options include the following:

Treating the Underlying Condition

Treating the cause of autoimmune hemolytic anemia may help treat the condition. Causes include cancer, medications, or collagen-vascular disease.

Corticosteroids

Cortisone-like drugs suppress the immune response. These drugs usually improve the more common types of autoimmune hemolytic anemia.

Other Immunosuppressive Drugs

Other drugs that suppress the immune system may be used if corticosteroids are not effective. These include azathioprine and cyclophosphamide. Rituximab is another drug that has shown promise in treating this condition.

Splenectomy

The spleen removes abnormal red cells from the circulation, including those labeled with antibodies. Removing the spleen can preserve those cells and prevent anemia.

Transfusion

You will need transfusions if your blood gets too anemic.

Prevention

It is not possible to prevent autoimmune hemolytic anemia. It has multiple causes.

Resources

American Academy of Family Physicians
http://familydoctor.org
National Organization for Rare Disorders, Inc.
http://www.rarediseases.org

Canadian Resources

Canadian Family Physician
http://www.cfp.ca/
Canadian Organization for Rare Disorders (CORD)
http://www.cord.ca

References

Autoimmune hemolytic anemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 10, 2012. Accessed November 12, 2012.
Dhaliwal G, Cornett PA, Tierney LM Jr. Hemolytic anemia. Am Fam Physician. 2004;69:2599-2606.
Lechner K, Jäger U. How I treat autoimmune hemolytic anemias in adults. Blood. 2010 Sep 16;116(11):1831-8.
Kasper DL et al., eds. Harrison's Principles of Internal Medicine. 16th ed. New York: McGraw-Hill; 2005.