Autoimmune hemolytic anemia is a health condition affecting red blood cells (RBCs). The immune system produces antibodies that specifically target red blood cells that carry oxygen across the body. It results in damaged and weakened RBCs.
Symptoms of Autoimmune Hemolytic Anemia
RBCs carry oxygen which is utilized in energy production in the body. The symptoms of autoimmune hemolytic anemia manifest as:
- Lack of energy and weakness
- Fatigue
- Shortness of breath
- Low hemoglobin levels
- Headache
- Fast heartbeat (tachycardia)
Besides, it can also burden the liver for RBCs recycling which may result in the:
- Jaundice
- Pale yellow skin
- Yellowing of eye whites
- Dark pee
Cold autoimmune hemolytic anemia can cause:
- Cold hands and feet
- Blue skin color on hands and feet
- Chest pain
- Heart murmuring
- Cardiac arrest
Causes and Risk Factors
Autoimmune hemolytic anemia can be triggered by:
- Pre-existing autoimmune conditions like lupus, Sjögren’s, Hashimoto’s, rheumatoid arthritis, etc.
- Viral infections like mumps, measles, hepatitis, etc.
- Genetic and environmental factors
- Medicines that interfere with the immune system like anti-cancer medicines and some antibiotics.
Like many other autoimmune conditions, the exact cause of autoimmune hemolytic anemia is yet to be determined.
Diagnosis of Autoimmune Haemolytic Anemia
Diagnosis of hemolytic anemia is done by a healthcare professional using a variety of tests. Preliminary tests include RBCs count and hemoglobin levels (full blood examination), peripheral smear, and bilirubin tests. If autoimmune hemolytic anemia is suspected, the physician may recommend further diagnostic tests to confirm the disease. Confirmatory tests include:
- Coombs’ Test: This test is done to check for antibodies against RBCs. In the case of autoimmune hemolytic anemia, Coombs’ test will be positive.
- LDH levels: Lactate dehydrogenase (LDH) enzyme is present inside RBCs. When RBCs are damaged, LDH will come out in the plasma and its levels will be higher than usual.
- Cold Agglutinin Titer: This test is performed to determine if autoantibodies bind to RBCs at a cold temperature. It is used to confirm cold autoimmune hemolytic anemia.
Treatment and Management of Autoimmune Hemolytic Anemia
Treatment of autoimmune hemolytic anemia depends on its severity. Mild hemolytic anemia may not require treatment. Physicians may recommend using corticosteroids like prednisone to subside the overactive immune system.
Immune suppressants like cyclophosphamide and azathioprine can be used in severe cases of autoimmune hemolytic anemia. Physicians may also recommend surgically removing the spleen. Spleen actively participates in destroying RBCs in autoimmune hemolytic anemia.
Outlook
Autoimmune hemolytic anemia could impact quality of life, as well as social and professional aspects of life. Although current treatments can effectively manage autoimmune hemolytic anemia, people suffering from hemolytic anemia may require support depending on their individual response to the treatment. It is important to stay vigilant and monitor your symptoms to avoid complications.
Many people living with autoimmune hemolytic anemia can spend a fulfilling life through self-care practices, adherence to medications, and seeking support when required.
