Do you always feel tired and weak? Do you get dizzy when you walk a little distance or climb a flight of stairs? Most of the time, we call this "anemia" or "anemia." It's true. But, have you ever thought that your own body's defense system, that is, the immune system, might be attacking and destroying your own red blood cells? Today we are talking about a rare disease that everyone is very important to be aware of. This is called Autoimmune Hemolytic Anemia , or (AIHA) for short.
Simply put, what is this AIHA?
To understand this, let's first look at what anemia is. Anemia is a decrease in the number of red blood cells in your body, which carry oxygen. These red cells are produced in our bone marrow. On average, one red blood cell lives for about 120 days. When these cells are depleted, the body's organs do not receive the necessary amount of oxygen. That's why we feel tired and lethargic.
Now, something very strange happens in AIHA. The immune system , which protects our body from disease, mistakenly identifies its own healthy red blood cells as "enemies." It's like a country's army attacking its own people. When the immune system starts destroying red blood cells in this way, they are lost at a rate that the bone marrow can't keep up with. Sometimes, the lifespan of a red blood cell is limited to just a few days. That's what we call Autoimmune Hemolytic Anemia (AIHA).
What are the main types of AIHA?
AIHA is classified into two main types. One is based on the cause. The other is based on the temperature at which the red blood cells are destroyed. Let's see what these are.
| Classification | Description |
|---|---|
| Primary AIHA | In this case, no other disease or cause can be found to cause AIHA. That is, this is an isolated condition. |
| Secondary AIHA | Here, AIHA is caused by another medical condition (e.g., other autoimmune diseases such as lupus, some types of cancer) or an infection. |
| Sorting by temperature | |
| Warm Autoimmune Hemolytic Anemia | This is the most common type. In this type, the immune system destroys red blood cells at or above normal body temperature. This is caused by a specific type of antibody called IgG. |
| Cold Autoimmune Hemolytic Anemia (CAD) | This is very rare. Another name for this is Cold Agglutinin Disease (CAD). In this, red blood cells are destroyed when the body is exposed to cold. The type of antibody responsible for this is IgM. |
What are the symptoms of this condition?
Many of the symptoms of AIHA are similar to those of other anemias, but some people may not have any symptoms at all if the destruction of red blood cells is severe enough.
Commonly seen symptoms:
- Weakness and fatigue: Extreme tiredness felt even after doing a little work.
- Pale skin: Paleness of the skin, lips, and nails.
- Tachycardia: A feeling that the heart is beating fast even when you are just standing still.
- Shortness of breath: This occurs when you are slightly tired.
- Chest pain.
- Yellowing of the eyes and skin (Jaundice): This is the condition we call jaundice.
- Dark urine: Urine that is dark in color, like cola.
- Feeling full: This is due to an enlarged spleen.
People with cold-type AIHA (CAD) may also experience these additional symptoms:
- Hands and feet are always cold.
- Hands and feet turning blue/red when exposed to cold.
- Headache.
- Back and leg pain.
What are the causes of AIHA?
Most of the time, it is difficult to find a specific cause for this condition (Primary AIHA). However, sometimes it can be caused by other medical conditions (Secondary AIHA).
- Other autoimmune diseases: For example, diseases like lupus.
- Certain types of cancer: especially blood-related cancers such as leukemia (Chronic Lymphocytic Leukemia) and lymphoma (Non-Hodgkin Lymphoma).
- Infections: Bacterial infections like *Mycoplasma pneumoniae*.
- Viruses: Viruses such as Epstein-Barr virus, HIV, and hepatitis.
- Some medications: This can also occur as a reaction to certain medications such as penicillin and methyldopa.
The important thing is that AIHA is not a contagious disease. It is a problem with the immune system. However, some viruses (e.g. Epstein-Barr) that can cause it can be transmitted from person to person.
How is the diagnosis made?
If you have symptoms of anemia, the first thing to do is see your doctor right away . He or she will ask you about your symptoms and the medications you are taking, and will examine you. If necessary, he or she will refer you to a hematologist.
Several blood tests are mainly performed for diagnosis.
- Complete Blood Count (CBC): This checks the number of red cells, white cells, and platelets. A low red cell count is a sign of anemia.
- Coombs' Test: This is the most specific test for AIHA. It checks whether your body is making antibodies against red blood cells.
- Peripheral Smear: A blood sample is examined under a microscope to look for signs of red cell destruction.
- Bilirubin Test: When red blood cells are destroyed, the level of a substance called bilirubin increases in the blood. This is what causes the yellow color.
- Reticulocyte Count: This measures the number of new immature red blood cells being produced by the bone marrow. A high number means that the bone marrow is working too hard to make new cells to replace the ones that are being destroyed.
What are the treatments for AIHA?
Treatment depends on the severity of your symptoms, the type of AIHA, and the cause. If your symptoms are not severe, treatment may not be necessary.
- Steroids: Steroid drugs like Prednisolone are the first line of treatment. These work by suppressing the immune system's activity and stopping it from destroying red blood cells.
- Other Immunosuppressants: If the disease does not respond to steroids, other drugs such as Rituximab are used.
- Splenectomy: Most of the time, the destruction of red blood cells occurs in the spleen. So if medication doesn't control it, doctors may decide to surgically remove the spleen.
- Blood Transfusion: If anemia is severe, blood transfusions may be necessary to save life.
- Protecting yourself from the cold (for Cold AIHA/CAD): If you have cold AIHA, protecting yourself from the cold is essential.
- Wear gloves when taking things out of the fridge.
- If you go out in cold weather, wear hats, scarves, and coats.
- If you're going to a place with a lot of AC, wear some warm clothes.
Your doctor may also recommend that you take a folic acid (vitamin B9) supplement, as this vitamin is needed for rapid red blood cell production.
What complications can occur due to this condition?
If AIHA is not treated properly, some complications can occur.
- Blood Clots: Blood clots can form in the veins, especially in the legs. If these travel to the lungs (Pulmonary Embolism), it is a very dangerous condition.
- Kidney damage: Uncontrolled AIHA can cause kidney damage.
- Heart disease: Long-term anemia causes the heart to work harder, which can weaken the heart.
There is no need to be afraid of these things. The most important thing is to get an accurate diagnosis and follow the doctor's instructions and treatment exactly. Then you can avoid many of these complications.
Take-Home Message
- Autoimmune Hemolytic Anemia (AIHA) is a rare condition in which your immune system mistakenly destroys your own red blood cells.
- If you have symptoms like frequent fatigue, paleness, difficulty breathing, and yellowing of the eyes, don't be lazy about it.
- If you have these symptoms, see a doctor immediately and seek advice. Do not self-medicate.
- AIHA is not a contagious disease, so there is no need to isolate a patient.
- With the right treatment, many people can control this condition well and live a normal life. So don't be afraid.
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න