Anemia (Autoimmune Hemolytic)

Autoimmune Hemolytic Anemia

Hematologic

Written by the doctors and editors at UpToDate
What is autoimmune hemolytic anemia? — Autoimmune hemolytic anemia is a type of 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 does not get all the oxygen it needs.
Autoimmune hemolytic anemia happens due to problems with the body's infection-fighting system, called the "immune system." Normally, the immune system kills germs. If something goes wrong and 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, doctors don't know what causes the condition. 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. Lymphomas are cancers that affect 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 these things do not lead to 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
Is there a test for autoimmune hemolytic anemia? — Yes. Doctors use blood tests to check for autoimmune hemolytic anemia. The most important one is called the direct antiglobulin test (also called the "Coombs test"). This test checks for signs of an immune attack on your red blood cells.
How is autoimmune hemolytic anemia treated? — Treatments can include:
Medicines that make your body's immune system less active, such as prednisone – This is usually the first thing doctors try.
Surgery to remove an organ called the spleen (called a "splenectomy")
Blood transfusion (if the anemia is very severe)
Other medicines, such as cyclophosphamide (brand name: Cytoxan) or rituximab (brand name: Rituxan), if the treatments listed above are 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.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 83062 Version 9.0
Release: 28.2.2 - C28.105
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