Autoimmune Hemolytic Anemia

Autoimmune Hemolytic Anemia: What Is It?

Autoimmune hemolytic anemia (AHA) applies to a number of conditions that group together and cause the immune system to kill off the red blood cells. This is very rare. The proteins that protect the body from infections and viruses (the antibodies) mistakenly believe that the red blood cells are something infections.

Most red blood cells will live for 120 days, approximately, but they become the immune system’s target and are destroyed earlier than they should. This leads to the body trying to create more red blood cells just to counter the destruction but it becomes difficult for the body to keep up with this over time and eventually the count of red blood cells drops. When there is a shortage of red blood cells, a person is diagnosed as anemic.

AHA can be a sudden medical condition but it can also take time to develop.

The Reasons and Types of Autoimmune Hemolytic Anemia

There are different forms of AHA and they are developed through different reasons.

About 50% of cases have no reason known and are known as idiopathic cases. The other 50% are due to illnesses. Some of those illnesses include:

  • Mononucleosis
  • Leukemia
  • Systemic lupus erythematosus

Some medications can also cause AHA. Penicillin and other sulfonamide antibiotics are commonly linked to this condition.

Autoimmune Hemolytic Anemia Risk Factors

More women will develop AHA than men. There are other risk factors including:

  • Family medical history of anemia
  • Having a viral infection
  • Having other certain types of autoimmune diseases
  • Taking some medications that can cause AHA
  • Having cancer, specifically leukemia
  • Being middle- or older-aged

Autoimmune Hemolytic Anemia Symptoms

Symptoms are not evident in all patients. Those that do have symptoms of AHA may include:

  • Pale skin/Jaundice
  • Weakness/tiredness
  • A faster heart rate
  • Short of breath
  • Fullness/discomfort in the abdomen
  • Pain in the muscles
  • Darker urine
  • Diarrhea, vomiting and nausea
  • Headaches

Autoimmune Hemolytic Anemia Diagnosis

Your doctor will do a full exam and ask you questions for a diagnosis of AHA. There are numerous tests that may be run and your doctor will want to check the size of your spleen.

Urine/Blood Tests:

Blood tests are used to check the count of red blood cells. Your doctor will check how many immature and young cells there are. If there is a high number, it could be a sign that your body is attempting to overcome the autoimmune disorder.

Urine tests can show how the cells are broken down in the body.

The direct Coombs test is used to check for the amount of antibodies that are attached to the red blood cells. This is specifically used for diagnosing AHA.

A cold agglutinins test will help to check if there are antibodies present due to infections, which could lead to AHA. One of these infections is Mycoplasma pneumoniae, which is a bacterium that infects the lungs and can cause pneumonia. It mostly affects those who are under 40 years old.

The Spleen

This is part of the lymphatic system and clears the dead red blood cells out of the system to protect it. It is to the left of your abdomen and behind the stomach. An enlarged spleen is a sign that it is overloaded with the dead or damaged red blood cells or it has done too much and is worn out.

To test for an enlarged spleen, your doctor will usually physically feel for it. An ultrasound is another option to measure the size.

Autoimmune Hemolytic Anemia Treatments

Those who have mild symptoms or where it is improving naturally will not usually get treatment.

Those who are anemic to a severe level can sometimes need to have a blood transfusion but this is only a temporary answer. There are other treatments needed.

When there is an underlying reason for the AHA, you will usually be given treatment for that. When it is due to the drugs that you take, you will be taken off them.

When the anemia gets worse or you have symptoms, you will usually find that you are given steroids. When these stop working, a surgeon may have to remove your spleen since this is where most of the red blood cells are destroyed.

When the removal of the spleen doesn’t work or this is not possible for other reasons, immunosuppressant drugs may be used. These medications help to stop the development of the antibodies attacking the red blood cells and suppress the immune system. They do lead to the possibility of catching other infections though and you may find that you are sick on a regular basis.

The Future for Autoimmune Hemolytic Anemia Patients

For some, the AHA will go completely and some don’t even need to have any treatment. However, this can be an ongoing, long-term problem that comes and goes in cycles.