Autoimmune Hemolytic Anemia (AIHA)
Autoimmune Hemolytic Anemia (AIHA
for short) is an autoimmune condition that attacks
the blood, destroying the red blood cells and causing
anemia. The anemia happens when the body is killing
more red blood cells than it can produce. AIHA can
be a primary condition or can be found in association
with other conditions and autoimmune diseases, such
as Lupus, Lymphoma and Chronic Lymphocytic Leukemia
and can occur at any age.
AIHA can present suddenly or gradually. Initial symptoms
may include fatigue (mostly due to the anemia), abdominal
pain, jaundice and an enlarged spleen. Most of the
red blood cell breakdown happens in the spleen, so
in severe cases removing the spleen may be considered.
There are different types of AIHA, and are classified
based on what is causing the breakdown. Besides the
Autoimmune response, other forms of Hemolytic Anemia
include abnormal proteins in the body, blood clots
in small vessels, infections, and some medications.
Symptoms:
Abdominal pain
Fatigue
Jaundice
Enlarged spleen
Dark urine
Pale skin
Shortness of breath
Diagnosis:
Diagnosis is usually made with blood tests and in
some cases a test called the Direct Coombs Test may
also confirm the diagnosis. Blood test results may
show:
Low Haptoglobin (Hp)
Elevated Lactate Dehydrogenase (LDH)
Elevated Total Bilirubin (T-Bili)
Elevated Reticulocytes
Treatment:
For mild cases or where cases are slow progression,
no treatment may be needed. For more severe cases,
Corticosteroids may be used, first at high doses and
then gradually tapering the dose over weeks to months.
Immunosuppressive therapy such as Cyclophosphamide
or Azathioprine may follow the Corticosteroids..
Sufferers unresponsive to Corticosteroid or immunosuppressive
therapy may consider removal of the spleen, since
production of red blood cells takes place in that
spleen.
Prognosis:
When AIHA presents in childhood, the prognosis is
usually better, where adults may experience a recurrence
or chronic episodes of Autoimmune Hemolytic Anemia.
With effective treatment and lifestyle adjustments,
most adults do well.
|
