Autoimmune Hemolytic Anemia

(Hemolytic Anemia)

by Ricker Polsdorfer, MD

---

Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

---

 

Definition

Autoimmune hemolytic anemia is a condition in which your body’s immune system mistakenly attacks its own red blood cells, causing them to disintegrate (hemolyze). This can be a serious, even lethal, condition that requires care from your doctor.

There are many causes of hemolysis, the breaking up of red blood cells. Some are congenital (eg, sickle cell disease), some are due to other diseases, and some are caused by drugs, but they all lead to anemia. The autoimmune hemolytic anemias, of which there are many types, occur when antibodies attack red blood cells.

 

Causes

In some cases of autoimmune hemolysis, medications may attach to red cells, leading to targeting for destruction by the immune system. The most common are penicillin and its relatives, cephalosporins, quinidine, and some anti-inflammatory drugs.

In most cases, however, abnormal immune function leads the body to attack normal red blood cells. Causes of the underlying abnormal immune function include:

• Drugs
  • Alpha-methyldopa
  • L-dopa
• Infections
  • Viral infections (including mononucleosis)
  • Mycoplasma pneumonia
• Cancers
  • Leukemia
  • Lymphoma ( Non-Hodgkin’s but also occasionally Hodgkin’s)
• Collagen-vascular (autoimmune) diseases (eg, lupus)

 

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors increase your chance of developing autoimmune hemolytic anemia:

• Recent viral infections
• Current medications of the types that can cause autoimmune hemolytic anemia
• Cancer or leukemia
• Collagen-vascular (autoimmune) disease
• Family history of hemolytic disease

 

Symptoms

If you experience any of these symptoms, do not assume the cause is due to autoimmune hemolytic anemia. These symptoms may be caused by many other health conditions. If you experience any one of them, see your physician.

• Dark brown urine
• Jaundice (yellow skin)
• Pallor (pale skin)
• Muscle pains
• Headache
• Nausea and vomiting
• Diarrhea
• Progressive weakness
• Shortness of breath
• Rapid heartbeat

 

Diagnosis

Your doctor will ask about your symptoms, medications, and medical history, and perform a physical exam. You will most likely be referred to a hematologist.

Tests may include the following:

• Extensive blood testing
• Urinalysis

 

Treatment

Talk with your doctor about the best treatment plan for you. Mild cases may need no treatment and resolve on their own. Treatment options include the following:

 

Prevention

Because of the multiple possible causes of autoimmune hemolytic anemia, prevention is not a consideration.

 RESOURCES:

Family Doctor
http://familydoctor.org/online/famdocen/home.html

National Organization for Rare Disorders, Inc.
http://www.rarediseases.org

 CANADIAN RESOURCES:

Canadian Organization for Rare Disorders (CORD)
http://www.cord.ca

Network of Rare Blood Disorders
http://www.hemophilia.ca

REFERENCES:

Beers MH, Berkow R. The Merck Manual . 17th ed. West Point, PA: Merck & Co; 1999.

Dhaliwal G, Cornett PA, Tierney LM Jr. Hemolytic anemia. Am Fam Physician . 2004;69:2599-2606.

Kasper DL et al., eds. Harrison's Principles of Internal Medicine . 16th ed. New York: McGraw-Hill; 2005.

---

Last reviewed September 2009 by Julie D. K. McNairn, MD
Last Updated: 9/30/09