Immune hemolytic anemia
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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, incidence, and risk factors
Immune hemolytic anemia occurs when antibodies form against the body's own red blood cells. The antibodies 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:
Complication of another disease
Past blood transfusions
Pregnancy (if the baby's blood type is different from the mother's)
Reaction to certain medications
Reaction to certain infections
If the cause of antibody formation is a disease or medication, it is referred to as secondary immune hemolytic anemia. Idiopathic autoimmune hemolytic anemia accounts for one-half of all immune hemolytic anemias.
Risk factors are related to the causes.
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.
Powers A, Silberstein LE. Autoimmune hemolytic anemia. In: Hoffman R, Benz Ej, Shattil SS, et al, eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 47.
Review Date: 1/31/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, 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 physician 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. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Anemia - immune hemolytic; Autoimmune hemolytic anemia (AIHA)
Symptoms
Signs and tests
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.
Powers A, Silberstein LE. Autoimmune hemolytic anemia. In: Hoffman R, Benz Ej, Shattil SS, et al, eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 47.
Review Date: 1/31/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, 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 physician 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. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Anemia - immune hemolytic; Autoimmune hemolytic anemia (AIHA)
Treatment
Treatment with a steroid medication such as prednisone is usually the first therapy tried. If a steroid medication does not improve the condition, removal of the spleen (splenectomy) may be considered. Treatments with drugs that suppress the immune system (immunosuppressants) may also be given if you do not respond to steroids.
Blood transfusions, if needed for severe anemia, are given with caution because the blood may not be compatible and it may cause further hemolysis.
Expectations (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.
Complications
Severe anemia rarely leads to death. Severe infection may occur as a complication of treatment with steroids, other medications that suppress the immune system, or splenectomy, because these treatments impair the body's ability to fight infection.
Calling your health care provider
Call your health care provider if you have unexplained fatigue or chest pain, or signs of infection.
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.
Powers A, Silberstein LE. Autoimmune hemolytic anemia. In: Hoffman R, Benz Ej, Shattil SS, et al, eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 47.
Review Date: 1/31/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, 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 physician 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. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Anemia - immune hemolytic; Autoimmune hemolytic anemia (AIHA)
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.
Powers A, Silberstein LE. Autoimmune hemolytic anemia. In: Hoffman R, Benz Ej, Shattil SS, et al, eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 47.
Review Date: 1/31/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, 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 physician 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. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 1/31/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, 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 physician 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. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.