Autoimmune hemolytic anemia - autoaggressive is a disease in which the red blood cells are destroyed due to the uncontrolled production of antibodies against its own erythrocytes. The disease most often affects women. Diagnosed this form of anemia is not based blood test. Disease treated with heavy use of immunosuppressive drugs, and often have to remove the spleen.
The causes of disease
Until the end it is established that causes the development of hemolytic anemia. The main predisposing factor - the development of antibodies to their own red blood cells, perceived by the body as foreign antigens. Anemia can occur as a complication on the background of the following diseases:
- chronic aggressive hepatitis;
- hemoblastosis;
- malignancies;
- ulcerative colitis.
Furthermore, autoimmune anemia may develop due to antibiotics of beta-lactam series (Ceftriaxone, Augmentin, Amoksiklava, penicillin). The appearance of anemia observed in the exacerbation of mycoplasma and cytomegalovirus infection.
Types and symptoms
There are the following species of hemolytic anemia:
- symptomatic, developing on the background of various diseases;
- idiopathic provoked by reasons that can not be set.
All manifestations of anemia does not depend on the etiological factor. Often the disease is characterized by a slowly progressive course. Among the first signs of autoimmune hemolytic anemia include:
- general weakness;
- abdominal pain;
- elevated body temperature;
- aching pain in the joints.
On examination, the patient there is a pronounced pallor of the skin, increasing jaundice, increase in size of the liver and spleen.
Often symptoms occur in autoimmune anemia suddenly. The patient begins to complain about the state of health, but during the examination, the doctor did not reveal any changes. The main complaints include:
- increased weakness;
- feeling short of breath;
- heart palpitations;
- decreased performance;
- nausea and vomiting;
- dizziness;
- headache;
- raising the temperature to 39 ° C;
- encircling the aching pain in the upper abdomen.
Diagnostics
Diagnosis of the disease includes assessment of the patient's complaints, the study of the history of the disease, and laboratory tests. The survey is conducted haematologist, rheumatologist, infectious disease specialist, allergist-immunologist and other specialists. During examination revealed pallor of the skin and mucous membranes, are well palpable enlarged liver and spleen.
The most important laboratory tests include:
- General blood analysis. It can detect changes in the ratio of different types of white blood cells in accordance with the disease, which is caused by autoimmune anemia. For idiopathic anemia is characterized by an increase in the number of monocytes and lymphocytes. When hypochromic anemia is violated hemoglobin concentration in the membrane of erythrocytes.
- Urinalysis, wherein the detected hemoglobinuria, urobilinemia, proteinuria.
- Blood chemistry. Increasing the total protein indicates the inflammatory process; increasing the number of indirect bilirubin occurs as a result of destruction of red blood cells; an increase in serum iron evidence of high rates of destruction of red blood cells.
- Coombs. This analysis is performed in order to detect antibodies in plasma, erythrocytes sensitive. If a positive response, then the diagnosis is confirmed.
- Linked immunosorbent assay. With the help of such an analysis are an idea about the number, type and class of immunoglobulins, which are involved in the autoimmune response. This suggests the mechanism of anemia.
- Sternal puncture. Lets examine the cellular composition of the bone marrow.
- Biopsy. Apply with inefficiency sternal puncture.
therapies
If diagnosed with autoimmune hemolytic anemia, the treatment should be complex. When symptomatic form of anemia get rid of the disease that caused its development. If anemia idiopathic, then held GCS therapy (corticosteroids), such as prednisone. Treatment of the disease is carried out by transfusion of washed packed red cells or whole blood.
Also carry out blood detoxification to remove the breakdown products of red blood cells. Cure autoimmune hemolytic anemia can be using plasmapheresis, thereby reducing the blood level of circulating antibodies. When assigning direct and indirect anticoagulants prevented the chance of developing DIC, which accompanies acute blood loss.
