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Autoimmune Hemolytic Anemia (AIHA)

Autoimmune hemolytic anemia

Autoimmune hemolytic anemia (AIHA) is an immune system disease. It causes red blood cells to break open or break down. 

The immune system's job is to attack germs that should not be in the body. In AIHA, the immune system attacks red blood cells and destroys them. This causes anemia. Anemia means your child’s red blood cell levels are low. 

Causes of AIHA

The cause of AIHA is not known. Some children may have a fever or infection a few days or weeks before developing AIHA. AIHA is not contagious. It does not pass from parents to their children.

Red blood cells

Autoimmune hemolytic anemia causes red blood cells to open or break down. Your child may have low red blood cell levels if they have this disease.

Symptoms of AIHA

Symptoms of AIHA include:

  • Pale skin
  • Decreased energy
  • Sleepiness
  • Fast heartbeat
  • Shortness of breath
  • Headache
  • Yellow color of skin and eyes (jaundice)
  • Dark urine

Treatment for AIHA

The first choice of treatment for AIHA is steroids. Your child will take these by mouth.

Some children may require a blood transfusion.

In some cases, steroids do not work well. Other treatments are needed. These treatments may include medicines given in a vein (IV), or in rare cases, surgery to remove the spleen.

Your child’s care team will discuss these treatments with you.

What are steroids?

Steroids are a type of drugs used to relieve swelling and inflammation. Some steroid drugs may stop tumor growth.

Source: National Cancer Institute

Steroid treatment side effects

Steroids have different effects on different children. Possible side effects include:

  • Stomach pain
  • Feeling more hungry than usual
  • Moodiness
  • Trouble sleeping
  • Flushing of the face
  • Weight gain, especially in the face and belly
  • Acne
  • Elevated blood pressure
  • Elevated blood sugar level
  • Increased risk of infection

Your child’s doctor will gradually decrease the dose of the steroids until they can be stopped completely. The side effects go away when the steroids are stopped.

Your child’s doctor may prescribe other medicines to help your child with side effects.

Recovery from AIHA

Most children only have AIHA for a few months. A few children will have AIHA that comes and goes over months to years. There is no way to know how quickly your child will recover from AIHA.

When to call your child’s care team

Reach out to your child’s care team if your child:

  • Looks pale
  • Has increased yellowing of the skin
  • Has dark urine
  • Is more tired than usual

Your child’s doctor might order a complete blood count test to determine next steps.

Reach out to your child’s care team if you have questions or concerns.

Key Points

  • Autoimmune hemolytic anemia (AIHA) is an autoimmune disease. It results in a decrease in the number of red blood cells.
  • AIHA does not have a known cause.
  • Treatments for AIHA include steroids.
  • Reach out to your child’s care team if you have questions.

Reviewed: August 2022