Idiopathic autoimmune hemolytic anemia is known as a rare collection of disorders which can strike the patient at any age group. Women are more affected by the condition than men, although in 50% of the cases, the causes cannot be identified.
This kind of anemia can be a result of or occur along with another illness like systemic lupus erythematosus; it also follows the usage of a few drugs like penicillin. What happens in the disease is that the red blood cells (RBC) are destroyed by auto antibodies suddenly. In other cases, the disease may extend slowly.
In some, the destruction of the RBC may be paused after a certain while, whereas in others, the condition may turn chronic. The two versions of AIHA are cold and warm antibody hemolytic anemia.
In cold antibody anemia, the auto antibodies turn active and affect RBC at a temperature below the standard body temperatures.
In the warm form of antibody anemia, the auto antibodies are attached to and destroy red blood cells at temperature which is of or higher than the usual body temperature.
Symptoms of Autoimmune Hemolytic Anemia
Some individuals with AIHA may not display any symptoms when there is mild destruction of the RBC and the progression is gradual. Other patients may demonstrate symptoms which are identical to those which accompany other kinds of anemia, when the annihilation is rapid and severe. With such destruction, the patient can also develop mild jaundice. If destruction continues for some months, the spleen can be enlarged, leading to discomfort and abdominal fullness.
If the anemia is a result of another disease, the indications of the latent disease like tender and swollen lymph nodes as well as fever may be prevalent. Some of the common symptoms of hemolytic anemia include:
- Enlarged spleen
- Dark colored urine
- Short breath
- Rapid heartbeat
- Yellow color of skin or jaundice
After the anemia is diagnosed by the doctor, they suspect an increased damage of immature RBC or reticulocytes. A blood examination can also determine increase of bilirubin, and decrease of the protein haptoglobin. The presence of autoimmune hemolytic anemia can be confirmed with the help of blood tests that detect the presence of enhanced numbers of antibodies which may be attached to the RBC (found through Coombs or direct antiglobulin test) or on the liquid part of your blood (found through Coombs or indirect antiglobulin test). There are also other tests which help establish the reasons of an autoimmune reaction which destroys the RBC.
Hemolytic anemia may be controlled and successfully treated. The progress of the anemia lies on the severity and cause of the condition. For gentle hemolytic anemia, you may not require treatment, while rigorous hemolytic anemia may be life impeding if allowed to go without treatment.
If the hemolytic anemia has been inherited, it requires treatment throughout life. In case it is resulted by a certain medicine or an infection, it may disappear once the illness is cured or if the medication is terminated.
Usually, a steroid medication is tried for the treatment of autoimmune hemolytic anemia. It is known as prednisone. If the condition is not improved with the help of steroid medications, the physician may consider elimination of the spleen through a process known as splenectomy.
Doctors may resort to immunosuppressive therapy if the patient does not respond well to splenectomy and steroids. Some of the common medications used in the process are cyclophosphamide (Cytoxan), rituximab (Rituxan) and Azathioprine (Imuran).
Any kind of blood transfusion should be undertaken cautiously since there are high chances that the blood may not match the patient’s and may aggravate hemolysis.
If the symptoms are less and the destruction of RBC slows down in itself, no treatment is required. If the destruction of the RBC worsens, prednisone may be administered in high doses followed with a slowing down over the subsequent months and weeks.
Plasmapheresis is often used to treat autoimmune hemolytic anemia. It includes the filtering of blood to eliminate antibodies and is usually helpful in case other cures fail. In case of severe obliteration of red blood cells, blood transfusions may be required, although they may offer temporary relief.