Resources
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Articles / Journals
Hill, Anita, and Quentin A Hill. “Autoimmune Hemolytic Anemia.” Hematology. American Society of Hematology. Education Program, U.S. National Library of Medicine, 30 Nov. 2018,
“Autoimmune Hemolytic Anemia – About the Disease.” Genetic and Rare Diseases Information Center, U.S. Department of Health and Human Services. Accessed 21 July 2024.
Professional, C. C. M. professional, Cleveland Clinic medical. “Autoimmune Hemolytic Anemia: Treatment, Symptoms & Types.” Cleveland Clinic. Accessed 21 July 2024.
“Autoimmune Hemolytic Anemia (AIHA).” (AIHA) | Boston Children’s Hospital. Accessed 21 July 2024.
What is Autoimmune Hemolytic Anemia (AIHA)?
Autoimmune hemolytic anemia is a rare blood cell immune disorder. The name for this disease can be broken down into two main parts:
- Autoimmune: The body mistakes healthy cells as foreign substances and attacks them
- Hemolytic Anemia: Which refers to red blood cells being destroyed at a rate faster than they are made
AIHA is a condition where the immune system mistakes red blood cells as foreign substances and directs its antibodies towards them. This causes the blood cells to burst, hence reduces the concentration in the blood. “When this happens, the lifetime of red blood cells decreases from 100 to 120 days to just a few days in serious cases.” and hence causes anemia. The causes of AIHA for half the cases remain unknown, but in the other half, it occurs with and is linked to other diseases and viruses, such as the ones listed below:
- Lupus
- Rheumatoid arthritis
- Sjogren’s syndrome
- Thyroid disease
- Ulcerative colitis
- Hashimoto’s disease
- Epstein-Barr virus
- Measles
- Mumps
- Rubella
- Atypical pneumonia
- Varicella
- HIV
- Hepatitis
- Cytomegalovirus
AHIA is a very rare disease affecting around “1 to 2 out of every 100,000 people each year” but it can affect anyone despite their gender or age (more commonly affects females over the age of 40). Many questions about AIHA being inherited have been raised – researchers believe that environmental and genetic influences play a huge role in developing AIHA, while some say that AIHA is a recessive gene and hence inherited in a very few families.
There are two main types of AIHA, the classification depending on the type of antibodies involved in the disease, they are:
- Warm Autoimmune Hemolytic Anemia: This is the most common type of AIHA and it “involves igG antibodies, which bind red blood cells at normal body temperature”. This means that the antibodies are active and cause hemolysis at normal body temperature. In the case of wAIHA, the red blood cells are destroyed prematurely at a high rate, much higher than the production rate at the haematopoiesis in the bone marrow.
- Cold Autoimmune Hemolytic Anemia: Affecting about 10% – 20% of the cases, cAIHA involves igM autoantibodies, which bind to the red blood cells at temperatures lesser than normal body temperature.
AIHA can also be divided into two subcategories in order to tell how the AIHA has been developed. These are:
- Primary AIHA
- Developed without the presence of an underlying cause
2.Secondary AIHA
- Developed with or linked to another disease, such as the ones listed above
The symptoms of AIHA include:
- Fatigue
- Paleness
- Jaundice
- Dark pee
- Enlargement of spleen
- Abdominal pain
- Leukocyte abnormality
- Heart failure
- Headaches
- Immunodeficiency
- Cancer originating in lymphocytes
- Muscle weakness
Since AIHA involves anemia, healthcare advisors will ask for a blood test in order to determine the complete blood count. In this test, red blood cell count, red blood cell size, hemoglobin presence and platelet count will be checked. Other tests to detect anemia can also be done, such as, Peripheral smear, Coombs’ test, Haptoglobin test, Bilirubin test etc.
“Mild cases of AIHA often require no treatment and resolve on their own.” But more intense cases can be fatal if not treated immediately through a blood transfusion. First, healthcare advisors will treat underlying conditions in cases of secondary AIHA. If it is primary AIHA, then healthcare advisors will prescribe corticosteroids (to help weaken the body’s immune response) or in more severe cases, immunosuppressants. If medications don’t work, then a splenectomy is advised in order to preserve red blood cells. These treatments work well for wAIHA, but for cases of cAIHA, healthcare advisors would advise to keep warm, stay in warm places or a warm climate all together.