Autoimmune Hemolytic Anemia (AIHA)

These instructions are for Children's Hospital of Philadelphia (CHOP) patients describe autoimmune hemolytic anemia (AIHA), where the body's immune system mistakenly attacks and destroys red blood cells.

Important information about anemia:

When there are too few red blood cells, or there is too little hemoglobin in the red blood cells, it is called anemia. Red blood cells are filled with a protein called hemoglobin. Hemoglobin is needed to deliver oxygen throughout our body. Learn more about anemia.

Autoimmune hemolytic anemia is a rare type of anemia. It happens when a person's immune system mistakenly attacks and destroys their own red blood cells. Specifically, the immune system creates antibodies against the red blood cells.

What are the symptoms of autoimmune hemolytic anemia?

• Feeling very tired, or weak

• Dizziness or headache

• Looking more pale than normal (pallor)

• Dark urine

• Fast heart rate (tachycardia)

• Shortness of breath

• A yellow color to the skin or whites of the eyes

• Sometimes nausea or vomiting.

• Decrease in appetite.

What causes autoimmune hemolytic anemia?

• In most young children, it develops after a viral infection.

• Rarely, it can be found with other autoimmune diseases, like lupus.

• Rarely, there is an underlying problem with the immune system.

• Sometimes we are not able to find the cause of AIHA.

How is autoimmune hemolytic anemia diagnosed?

A hematologist, a specialist for blood disorders, will be involved in your child's care. They will ask questions about your child's current illness, medical history and family history. They order urine and blood tests and look at the blood under the microscope.

How is autoimmune hemolytic anemia treated?

Treatment will depend on the type, severity and cause of autoimmune hemolytic anemia.

• Often corticosteroids, such as prednisone pr prednisolone, are the first medicine prescribed. Corticosteroids calm your child's immune system down, so it stops destroying the red cells. There are other medicines that can also be used to change the immune system.

• If too many red blood cells have been destroyed, a blood transfusion may be needed.

• In the beginning, we may need to check blood count frequently (blood draws) to make sure that the hemoglobin is at a safe level.

Patient instructions:

• Watch closely for the symptoms your hematology team reviewed with you.

• Give your child all medicines exactly as prescribed. Do not stop any medicines early or give extra doses!

• Go to all scheduled lab draws and follow-up appointments. Please let us know if you need help with work or other childcare arrangements.

• Call your hematology team about any symptoms, or if your child is not able to take any of their medicines as ordered.

Please contact your CHOP hematology team with questions or concerns:

Division of Hematology

215-590-3535

For non-urgent issues, send your team a message in the MyCHOP portal.

Reviewed on June 23, 2023, by Diane Gardella, RN