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Auto-immune haemolytic anaemia: Treatment, symptoms, advice and help

About auto-immune haemolytic anaemia

Auto-immune haemolytic anaemia is a rare disease characterised by increased destruction of blood forming cells called red blood cells (RBCs). This occurs as a result of impairment of one’s immune system which produces auto antibodies against red blood cells.

Auto-immune haemolytic anaemia: incidence, age and sex

Auto-immune haemolytic anaemia can be seen in any age group and occur more commonly in women.

Signs and symptoms of auto-immune haemolytic anaemia: Diagnosis

The red blood cells and their haemoglobin content are responsible for the oxygen carrying capacity of blood which reduces markedly, in this disorder. The clinical features resemble that of anaemia and depend upon the severity of disease. An affected individual may be asymptomatic or experience vague symptoms like persistent exhaustion, loss of appetite, palpitations and shortness of breath. A detailed physical examination by the doctor may reveal pallor of skin and conjunctiva or irregularities in heart beat on auscultation of the chest. In severe stage of the disease, the skin may become yellow (jaundice) and patient may complain of abdominal discomfort which may result from an enlargement of an abdominal organ called spleen.

The course of this disease is variable in different individuals. The destruction of red blood cells may be long-standing or intermittent with episodes of remissions and relapses. The destruction of red blood cells may wane as age advances or may stop altogether. The doctor may advice some blood tests like red blood cell count, haemoglobin, reticulocyte count, bilirubin, direct and indirect Coomb’s test which will help in establishing the diagnosis of auto-immune haemolytic anaemia.

Causes and prevention of auto-immune haemolytic anaemia

Normally the immune system of the body provides protection against foreign bodies by producing antibodies against them, which eventually lead to their destruction. In auto-immune haemolytic anaemia, the antibodies get turned against body’s own red blood cells resulting in their increased rate of destruction. The exact cause of this phenomenon is not yet known.

Auto-immune haemolytic anaemia: Complications

Severe anaemia or low haemoglobin count is one of the most serious results of this disorder. Severe anaemia may cause loss of concentration and decreased physical tolerance to exertional activity. There is an increased risk of infections in an individual who is on medications for auto-immune haemolytic anaemia.

Auto-immune haemolytic anaemia: Treatment

The oral steroids like prednisolone are the medications of choice in treating auto-immune haemolytic anaemia. These steroids are prescribed in high dose and tapered gradually. Most of the individuals improve with these drugs. But some individuals in whom no improvement is noted or in those with inability to continue medications due to adverse effects, then surgery should be taken into consideration. Surgical procedure, splenectomy in which spleen is removed may help in increasing the life span of red blood cells. Medications like immunosuppressant drugs are another option if both steroids and splenectomy fail to bring improvement in patient’s condition. But such patients are quite susceptible to frequent infections. Occasionally blood transfusions may help in providing temporary relief. Unfortunately auto-immune haemolytic anaemia is a life-long disease with no permanent treatment.