AIHA – Autoimmune Hemolytic Anemia
The autoimmune hemolytic anemia is a condition in which there is a reduced number of blood cells because of their premature destruction by the immune system.
CAUSES: The autoimmune hemolytic anemia occurs when antibodies act against the red blood cells of your body. The antibodies destroy the blood cells because the immune system mistakenly recognizes these cells as foreign bodies within the body.
This can be caused by:
• Complication of another disease;
• Blood transfusions in the past;
• Pregnancy (if the baby’s blood type is different from that of the mother);
• Reaction to medicines;
• Reaction to certain infections.
If the cause of antibody formation is disease or medication, it is called as autoimmune hemolytic anemia secondary. L ‘idiopathic autoimmune hemolytic anemia occurs in half of all cases of immune hemolytic anemias. Risk factors are related to the causes.
Autoimmune Hemolytic Anemia Symptoms
Symptoms: The most common are:
• Dark urine;
• Paleness or jaundice;
• Rapid heart rate;
• Shortness of breath.
DIAGNOSIS: The tests will be performed:
• Absolute reticulocyte count;
• Coombs direct and indirect;
• Hemoglobin in the urine;
• LDH (level of this enzyme increases due to damage to the tissues);
• Number of red blood cells, hemoglobin and hematocrit;
• Serum bilirubin;
• Serum hemoglobin;
• Serum haptoglobin.
Autoimmune Hemolytic Anemia Treatment
Treatment with steroids such as prednisone is usually the first therapy tried. If a steroid medication does not improve the condition, removal of the spleen (splenectomy) it may be considered. Treatments with drugs that suppress the immune system (immunosuppressants) may be administered although do not respond to steroids. Blood transfusions, if needed for severe anemia, are given with caution, because the blood may not be compatible and may cause further hemolysis.
PROGNOSIS: The disease can begin early and be very serious, or it may remain mild and not require specific treatment. In most people, steroids or splenectomy are able to control the ‘anemia. In other treatment can usually partially control the ‘anemia.
Possible complications are rarely death in severe cases, and infections that can occur as a complication of treatment with steroids, other drugs that suppress the immune system, or splenectomy, because these treatments impair the body’s ability to fight infections.
Call your doctor if you suffer from unexplained fatigue, chest pain or signs of infection.
PREVENTION: Screening for antibodies in donated blood and in the recipient may prevent ‘hemolytic anemia related to blood transfusions.
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