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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Adult and Senior Health Immune Hemolytic Anemia

Immune Hemolytic Anemia

Immune hemolytic anemia or autoimmune hemolytic anemia or AIHA is a type of hemolytic anemia in which body's red blood cells or RBC's are destroyed by the body's own immune system.


In other words it could be concluded that the body treats her own red blood cells as antigens and produces antibodies against them which in turns lead to their destruction by a process called as hemolysis leading to anemia. The condition is also known as immunohemolytic anemia as it can occur by drug reactions also. Immune complex hemolytic anemia is the other name to the condition. Hemolysis occurs by a complex process which include antibodies and associated complement system components become fixed onto the RBC surface which stimulates either macrophages for the destruction or the complement activation pathway can itself destruct the RBC's. The drugs which can lead to the immune hemolytic anemia include methyldopa, fludarabine and many others.

Types of Auto Immune Hemolytic Anemia

  • Warm autoimmune hemolytic anemia
  • Cold agglutinin disease
  • Paroxysmal cold hemoglobinuria

Types of Hemolysis

  • Intravascular hemolysis - includes the destruction of red blood cells in the circulation as a result of activation of the complement system cascade.
  • Extravascular hemolysis - In this type red blood cells are destroyed by macrophages who detect them by the coating antibody in the reticuloendothelial system.

Diagnosis and Investigations

  • Increased serum unconjugated bilirubin
  • Increased urinary urobilinogen
  • Reduced plasma haptoglobin
  • Increased serum lactic dehydrogenase or LDH
  • Reticulocytosis which shows increased RBS production
  • Erythroid hyperplasia of the bone marrow shows increased RBS production
  • Direct Coombs test will be positive in the affected individuals