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</div><div><span>Immune hemolytic anemia</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Immune hemolytic anemia</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to the body's tissues.</p><p>Red blood cells last for about 120 days before the body gets rid of them. In hemolytic anemia, red blood cells in the blood are destroyed earlier than normal.</p><p>Immune hemolytic <a test="test" href="./000560.htm">anemia</a> occurs when antibodies form against the body's own red blood cells and destroy them. This happens because the immune system mistakenly recognizes these blood cells as foreign.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>Possible causes include:</p><ul><li>Certain chemicals, medicines, and toxins</li><li>Infections</li><li>Transfusion of blood from a donor with a blood type that does not match</li><li>Certain cancers </li></ul><p>When <a test="test" href="./002223.htm">antibodies</a> form against red blood cells for no reason, the condition is called idiopathic autoimmune hemolytic anemia.</p><p>The antibodies may also be caused by:</p><ul><li><div>A complication of another disease</div></li><li><div>Past blood transfusions</div></li><li><div>Pregnancy (if the baby's blood type is different from the mother's)</div></li></ul><p>Risk factors are related to the causes.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>You may not have symptoms if the anemia is mild. If the problem develops slowly, symptoms that may occur first include:</p><ul><li>Feeling weak or tired more often than usual, or with exercise</li><li>Headaches</li><li>Problems concentrating or thinking </li></ul><p>If the anemia gets worse, symptoms may include:</p><ul><li>Lightheadedness when you stand up</li><li>Pale skin color (<a test="test" href="./003244.htm">pallor</a>)</li><li><a test="test" href="./003075.htm">Shortness of breath</a></li><li>Sore tongue </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>You may need the following tests:</p><ul><li>Absolute <a test="test" href="./003637.htm">reticulocyte count</a></li><li>Direct or indirect <a test="test" href="./003344.htm">Coombs test</a></li><li><a test="test" href="./003645.htm">Hemoglobin</a> in the urine</li><li><a test="test" href="./003471.htm">LDH</a> (level of this enzyme rises as a result of tissue damage)</li><li><a test="test" href="./003644.htm">Red blood cell count</a> (RBC), hemoglobin, and <a test="test" href="./003646.htm">hematocrit</a></li><li>Serum <a test="test" href="./003479.htm">bilirubin</a> level</li><li><a test="test" href="./003634.htm">Serum haptoglobin</a></li><li>Donath-Landsteiner test</li><li>Cold agglutinins</li><li>Platelet count</li><li>Protein electrophoresis - serum</li><li>Pyruvate kinase</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>The first treatment tried is most often a steroid medicine, such as prednisone. If a steroid medicine does not improve the condition, treatment with intravenous immunoglobulin (IVIG) or removal of the spleen (splenectomy) may be considered.</p><p>You may receive treatment to suppress your immune system if you do not respond to steroids. Medicines such as azathioprine (Imuran), cyclophosphamide (Cytoxan), and rituximab (Rituxan) have been used.</p><p>Blood transfusions are given with caution, because the blood may not be compatible and it may cause more red blood cell destruction.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>The disease may start quickly and be very serious, or it may stay mild and not need special treatment.</p><p>In most people, steroids or splenectomy can totally or partially control anemia.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Severe anemia rarely leads to death. Severe infection may occur as a complication of treatment with steroids, other medicines that suppress the immune system, or splenectomy. These treatments impair the body's ability to fight infection.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Contact your health care provider if you have unexplained fatigue or chest pain, or signs of infection.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-8" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-8"><p>Screening for antibodies in donated blood and in the recipient may prevent hemolytic anemia related to blood transfusions. </p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Anemia - immune hemolytic; Autoimmune hemolytic anemia (AIHA)</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/9069t.jpg" alt="Antibodies" title="Antibodies" class="side-img"/><a href="../imagepages/9069.htm">Antibodies</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Michel M. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Cooney KA, eds. <em>Goldman-Cecil Medicine</em>. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 146.</p><p>Michel M, Jäger U. Autoimmune hemolytic anemia. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. <em>Hematology: Basic Principles and Practice</em>. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 47.</p><p>Wong E, Rose MG, Berliner N. Disorders of red blood cells. In: Wing EJ, Schiffman FJ, eds. <em>Cecil Essentials of Medicine</em>. 10th ed. Philadelphia, PA: Elsevier; 2022:chap 48.</p></div></div></section>
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