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Antibodies
Antibodies


Definition:

Immune hemolytic anemia is a condition in which there is a reduced blood cell count due to the premature destruction of red blood cells by the immune system.



Alternative Names:

Anemia - immune hemolytic; Autoimmune hemolytic anemia (AIHA)



Causes, incidence, and risk factors:

Immune hemolytic anemia occurs when antibodies form against the body's own red blood cells. The antibodies will destroy the blood cells because the immune system mistakenly recognizes these blood cells as foreign material within the body. The antibodies may be caused by:

  • Blood transfusion
  • Complicaton of a disease
  • Pregnancy (if the baby's blood type is different from the mother's)
  • Reaction to medications

If the cause of antibody formation is disease or medication, it is referred to as secondary immune hemolytic anemia. If the cause is unknown, it is called idiopathic autoimmune hemolytic anemia . This type of anemia accounts for one-half of all immune hemolytic anemias .

Risk factors are related to the causes.



Signs and tests:

Treatment:

Treatment with a steroid medication such as prednisone is usually the first therapy tried. If a steroid medication does not improve the condition, removal of the spleen (splenectomy ) may be considered. Treatments with drugs that suppress the immune system (immunosuppressants) may also be given if you do not respond to steroids.

Blood transfusions, if needed for severe anemia, are given with caution because the blood may not be compatible and it may cause further hemolysis.



Support Groups:



Expectations (prognosis):

The disease may start quickly and be very serious, or it may remain mild and not need specific treatment.

In most people, steroids or splenectomy can control anemia. In others, treatment can usually partially control the anemia.



Complications:

Severe anemia rarely leads to death. Overwhelming infection may occur as a complication of treatment with steroids, other medications that suppress the immune system, or splenectomy, because these treatments reduce the body's ability to fight infection.



Calling your health care provider:

Call your health care provider if you have unexplained fatigue or chest pain, or signs of infection.



Prevention:

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



References: Schwartz RS. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 164.


Review Date: 11/23/2008
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100