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Date of last update: 10/12/2017.

Forum Name: Hematology Topics

Question: Is it immune hemolytic aneamia

 belindabea - Mon Oct 10, 2005 5:29 am

I`m 50 yr old female. Caught mononeucelosis 3 yrs ago and havent been the same since.
My Hb at the time was down to 6.6, I had jaundice and felt very poorly. I was found to be deficient in B12 and folic acid.Took iron for 6 months and it seemed as if all was going ok. Had regular check ups and 3months ago my blood started dropping again down to 8.9 with accompaning jaundice, although liver function tests are ok.
They think I have an immune hemolytic aneamia, but this is proving difficult to confirm.I have an enlarged spleen but they don't want to remove it yet and although I had a bone marrow biopsy done 3yrs ago they want to do another and a CAT scan too.
Any thoughts on the matter would be gratefully received. I am desperate for an answer after so long.
Is there anything that I can do to correct the enlarged spleen, is it ok to drink alcohol?
Many thanks in anticipation,
 Dr. Safaa Mahmoud - Sun Jul 16, 2006 9:19 pm

User avatar Dear belindabea,

Autoimmune hemolytic anemia occurs when antibodies that are formed by the body immune system attacks its own red blood cells.
Autoimmune hemolytic anemia occurs in many conditions that include:
o infections, such as hepatitis, cytomegalovirus (CMV), Epstein-Barr virus (EBV), typhoid fever, E. coli (escherichia coli), or streptococcus
o medications, such as penicillin, antimalaria medications, sulfa medications, or acetaminophen
o leukemia or lymphoma
o autoimmune disorders, such as systemic lupus erythematous (SLE, or lupus), rheumatoid arthritis, Wiskott-Aldrich syndrome, or ulcerative colitis
o various tumors
In suche cases Autoimmune hemolytic anemia is named secondary immune hemolytic anemia.

When the cause is not recognized, it is named idiopathic autoimmune hemolytic anemia.

Symptoms of hemolytic anemia include:
Pale skin
Shortness of breath
Rapid heart rate
Enlarged spleen
And in severe cases juandice and dark urine.

Lab results such cases include:
Positive direct Coombs' test or indirect Coombs' test
Elevated bilirubin levels
Elevated LDH
Low serum haptoglobin
Hemoglobin in the urine
Elevated absolute reticulocyte count
Low red blood cell count

Steroids - Prednisone is usual upfront treatment. splenectomy is considered in steroid nonresponding cases.
While, Immunosuppressive therapy is given if there is no response to prednisone and splenectomy.

I hope these informations are helpful.

Best regards,

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