MedlinePlus Medical Encyclopedia: Immune hemolytic anemia

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Immune hemolytic anemia

Contents of this page:
Illustrations Alternative names Definition Causes, incidence, and risk factors Symptoms Signs and tests	Treatment Expectations (prognosis) Complications Calling your health care provider Prevention

Illustrations

Antibodies

Alternative names Return to top

Anemia - immune hemolytic

Definition Return to top

Immune hemolytic anemia is a disorder characterized by anemia due to premature destruction of red blood cells by the immune system.

Causes, incidence, and risk factors Return to top

Immune hemolytic anemia occurs when antibodies form against the body's own red blood cells. The antibodies may be acquired by blood transfusion, pregnancy (if the baby's blood type is different from the mother's), as a complication of another disease, or from a reaction to medications.

If the cause of antibody formation is disease or medication, it is referred to as secondary immune hemolytic anemia. The antibodies will destroy the blood cells because they are recognized as foreign substances within the body.

The cause may also be unknown, as in idiopathic autoimmune hemolytic anemia, which accounts for one-half of all immune hemolytic anemias. The onset of the disease may be quite rapid and very serious, or it may remain mild and not require specific therapy. Risk factors are related to the causes.

Symptoms Return to top

Signs and tests Return to top

Positive direct Coombs' test or indirect Coombs' test
Elevated bilirubin levels
Elevated LDH
Low serum haptoglobin
Hemoglobin in the urine
Elevated absolute reticulocyte count
Low red blood cell count and hemoglobin

Treatment Return to top

Treatment with prednisone is the first therapy that is tried. If prednisone does not improve the condition, a splenectomy (removal of the spleen) may be considered. Immunosuppressive therapy will be given if the person does not respond to prednisone and splenectomy.

Blood transfusions are given with caution, if indicated for severe anemia because of the potential that blood may not be compatible and it may precipitate a reaction.

Expectations (prognosis) Return to top

In most people, steroids or splenectomy control anemia. In others, partial control of the anemia is usually achieved.

Complications Return to top

Death rarely occurs from severe anemia. Overwhelming infection may occur as a complication of therapy with steroids or splenectomy, since they reduce the body's ability to fight infection.

Calling your health care provider Return to top

Call your health care provider if unexplained fatigue or chest pain occurs, or if signs of infection are present.

Prevention Return to top

Screening for antibodies in donated blood and in the recipient may prevent hemolytic anemia related to blood transfusions.

Update Date: 5/2/2003

Updated by: Ezra E. W. Cohen, M.D., Section of Hematology/Oncology, Department of Medicine, The University of Chicago, Chicago, IL. Review provided by VeriMed Healthcare Network.

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