By: Katie Smith

Alternative Names  Idiopathic autoimmune anemia  Anemia

How can you get it?  It can be inherited or acquired. AIHA is a group of disorder characterized by a malfunction of the immune system that produces antibodies, which attack red blood cells as if they were substances foreign to the body.  There are three thermal types: warm, cold and biphasic. Warm is the most common.  Some causes are: Drugs- fludarabine interferon alfa Cancers- Lymphoma Leukemia Infections- Mycoplasma pneumonia Viral infections

Symptoms  Dark Urine  Enlarged spleen and liver  Fatigue  Pale color (pallor)  Rapid heartbeat  Shortness of breath  Yellow skin color (jaundice)

Diagnosis  Direct Coomb’s test  Hemoglobin in the urine  Indirect Coomb’s test  Red blood cell count and serum hemoglobin  Reticulocyte count  Serum bilirubin levels  Serum haptoglobin

Treatments  The first therapy tried is usually a steroid medication, such as prednisone. If steroid medications do not improve the condition, removal of the spleen (splenectomy) may be considered. Immunosuppressive therapy is usually given if the person does not respond to steroids and splenectomy. Medications such as Azathioprine (Imuran), cyclophosphamide (Cytoxan), and rituximab (Rituxan) have been used.Blood transfusions are given with caution, because of the potential that blood may not be compatible and may cause further hemolysis. Children under the age of 5 cannot live without their spleens.

Interesting Facts  At the end of June 2005 my brother Jake had been diagnosed with a viral infection. By July he kept getting weaker with no explanation as to why, because the viral infection he’d had was gone. The doctor ran several different test and his hemoglobin level was dropping each time they checked it, at that point they diagnosed him with hepatitis. They called the following Tuesday to say that was no longer his diagnoses they couldn’t figure out what he had, my mom scheduled an appointment for Friday with the pediatrician. In the mean time, they’d faxed his results of his lab test to a pediatric Gastrointestinal specialist at Swedish American Hospital telling him that Jake needed to be seen some time in the next couple of weeks. After seeing the test results that same Tuesday the specialist wanted him in his office that same day. We took him in to his office where they ran more test, upon seeing the results he determined he wouldn’t be able to help us- he did however have the pediatric hematologist who’d just started on staff the day before come and consult with him on the case. Dr. Salahma had us take him to Rockford Memorial Hospital where he was admitter to the P.I.C.U ( pediatric intensive care unit). He had hematuria, chills, fatigue, enlarged liver and spleen and had begun vomiting (he was vomiting because his liver couldn’t process meat). They ran more blood test and by 2 a.m. his hemoglobin level was down to 2, they had to give him a blood transfusion. None of his blood tests were coming back with positive results so he was scheduled for a bone marrow biopsy the following morning. On Thursday after undergoing the bone marrow biopsy they got the results of the indirect coomb’s test back. They started him on a 6 week round of steroids to speed the antibodies up so they’d eat themselves up and die out. He had autoimmune hemolytic anemia which was triggered by warm antibodies. We had to keep him occupied with sedate activities for a 6 month time period after his release so he wasn’t risking injuries that could cause him to bleed; as his body needed that length of time to regenerate the blood that was eaten up by the antibodies.

Work Cited  Google, Web. 21 Jan  Singapore Medical Journal. Web. 24 Jan  -83b7-472d-a7ab-bc f86&chunkiid= EBSCO Publishing, Sept Web. 24 Jan