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Autoimmune Hemolytic Anemia

Autoimmune Hemolytic Anemia Diagnosis

Once a doctor diagnoses anemia, increased destruction of red blood cells is suspected when a blood test shows an increase in the number of red blood cells that are immature (reticulocytes). Alternatively, a blood test may show an increased amount of a substance called bilirubin and a decreased amount of a protein called haptoglobin.

Autoimmune hemolytic anemia as the cause is confirmed when blood tests detect increased amounts of certain antibodies, either attached to red blood cells (direct antiglobulin or Coombs test) or in the liquid portion of the blood (indirect antiglobulin or Coombs test). Other tests sometimes help determine the cause of the autoimmune reaction that is destroying red blood cells.

Treatment

If symptoms are mild or if destruction of red blood cells seems to be slowing on its own, no treatment is needed.

If a drug has caused the problem, the offending drug needs to be stopped.

If red blood cell destruction is worsening, a corticosteroid drug such as prednisone is usually the first choice for treatment. High doses are used at first, followed by a gradual tapering of the dose over many weeks or months.

I.V.I.g may be used when steroids are ineffective.

Plasmapheresis, which involves filtering blood to remove antibodies, is occasionally helpful when other treatments fail. When red blood cell destruction is severe, blood transfusions are sometimes needed, but they do not treat the cause of the anemia and provide only temporary relief.


Role of intravenous immunoglobulin G in autoimmune hematologic disorders.

The data presented in this review established IVIG therapy as an important treatment modality in the autoantibody-mediated cytopenias and coagulation disorders of both children and adults.