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Immune hemolytic anemia

Definition

Immune hemolytic anemia is a condition in which there is a reduced blood cell count due to the premature destruction of red blood cells by the immune system.

Alternative Names

Anemia - immune hemolytic; Autoimmune hemolytic anemia (AIHA)

Causes

Immune hemolytic anemia occurs when antibodies form against the body's own red blood cells. The antibodies will destroy the blood cells because the immune system mistakenly recognizes these blood cells as foreign material within the body. The antibodies may be caused by:

Blood transfusion
Complicaton of a disease
Pregnancy (if the baby's blood type is different from the mother's)
Reaction to medications

If the cause of antibody formation is disease or medication, it is referred to as secondary immune hemolytic anemia. If the cause is unknown, it is called idiopathic autoimmune hemolytic anemia. This type of anemia accounts for one-half of all immune hemolytic anemias.

Risk factors are related to the causes.

Symptoms

Dark urine
Enlarged spleen
Fatigue
Pale (pallor) or yellow (jaundice) skin color
Rapid heart rate
Shortness of breath

Exams and Tests

Absolute reticulocyte count
Direct or indirect Coombs' test
Hemoglobin in the urine
LDH (level of this enzyme rises as a result of tissue damage)
Red blood cell count (RBC) and hemoglobin
Serum bilirubin levels
Serum free hemoglobin
Serum haptoglobin

Treatment

This version of the Encyclopedia has no treatment information. Please discuss any and all treatment options for your condition with your healthcare professional.

Outlook (Prognosis)

The disease may start quickly and be very serious, or it may remain mild and not need specific treatment.

In most people, steroids or splenectomy can control anemia. In others, treatment can usually partially control the anemia.

Possible Complications

Severe anemia rarely leads to death. Overwhelming infection may occur as a complication of treatment with steroids, other medications that suppress the immune system, or splenectomy, because these treatments reduce the body's ability to fight infection.

When to Contact a Medical Professional

Call your health care provider if you have unexplained fatigue or 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.

References

Schwartz RS. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 164.

Review Date: 11/23/2008
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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