Anemia is a low level of healthy red blood cells (RBCs). RBCs carry oxygen from the lungs to the rest of the body. Low levels of RBCs make it hard to get enough oxygen throughout the body. This can cause symptoms such as fatigue, pale skin, or irregular heartbeat.

Autoimmune hemolytic anemia is caused by the destruction of RBCs. It can be a serious, fatal condition that will need medical care.

Red Blood Cells
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This type of anemia is caused by a problem with the immune system. For some reason, the immune system starts to make antibodies that attack red blood cells. Medicine or other illnesses may cause this change in the immune system.

Risk Factors

The risk of autoimmune hemolytic anemia may be higher in those with:


Symptoms may include:

  • Dark brown urine
  • Yellow or pale skin
  • Muscle pains
  • Headache
  • Nausea and vomiting
  • Diarrhea
  • Weakness
  • Shortness of breath
  • Rapid heartbeat


You will be asked about your symptoms and past health. A physical exam will be done. Anemia may be suspected based on symptoms. A blood test will confirm low levels of RBCs. There are different types of anemia. Other tests will confirm the type.


Mild cases of anemia may not need treatment. They may get better on their own. If treatment is needed, steps may include:

  • Treat the related cause. Anemia may pass or improve once the cause is managed. Medicine may need to be stopped or changed.
  • Slow or stop damage to RBCs by lowering immune system with:
    • Corticosteroids
    • Other long-term medicine
  • A blood transfusion will quickly replace RBCs. It will be a quick fix since RBC levels will fall again if the cause is not managed.

The spleen is a small organ near the stomach. It helps to clear out old and damaged RBCs. Anemia can cause an enlargement of the spleen. This can then make anemia worse. The spleen may need to be removed if it is causing problems.


There are no steps to prevent autoimmune hemolytic anemia.


Family Doctor—American Academy of Family Physicians

NORD—National Organization for Rare Disorders


Canadian Blood Services

Health Canada


Autoimmune hemolytic anemia. EBSCO DynaMed website. Available at: Updated August 7, 2019. Accessed September 9, 2019.

Autoimmune hemolytic anemia. Merck Manual Professional Version website. Available at: Updated March 2019. Accessed September 9, 2019.

Dhaliwal G, Cornett PA, et al. Hemolytic anemia. Am Fam Physician. 2004;69(11):2599-2606.

Lechner K, Jäger U. How I treat autoimmune hemolytic anemias in adults. Blood. 2010;116(11):1831-1838.

Last reviewed September 2019 by EBSCO Medical Review Board Marcin Chwistek, MD  Last Updated: 7/28/2020