Summary about Disease
Warm autoimmune hemolytic anemia (WAIHA) is a type of autoimmune hemolytic anemia (AIHA) where the body's immune system mistakenly attacks and destroys its own red blood cells at body temperature (37°C or 98.6°F). This leads to a shortage of red blood cells, resulting in anemia. The antibodies involved are typically IgG.
Symptoms
Common symptoms include:
Fatigue
Weakness
Pale skin (pallor)
Jaundice (yellowing of the skin and eyes)
Dark urine
Shortness of breath
Dizziness
Rapid heart rate
Enlarged spleen (splenomegaly)
Enlarged liver (hepatomegaly)
Causes
The exact cause of WAIHA is often unknown (idiopathic). However, it can be associated with:
Other autoimmune diseases (e.g., systemic lupus erythematosus (SLE), rheumatoid arthritis)
Certain infections (e.g., mycoplasma pneumonia, Epstein-Barr virus (EBV))
Lymphoproliferative disorders (e.g., lymphoma, chronic lymphocytic leukemia (CLL))
Certain medications (e.g., methyldopa, penicillin, cephalosporins)
Cancers
Medicine Used
Common medications used to treat WAIHA include:
Corticosteroids (e.g., prednisone): First-line treatment to suppress the immune system.
Rituximab: A monoclonal antibody that targets B cells (immune cells that produce antibodies).
Splenectomy: Surgical removal of the spleen (sometimes considered if other treatments fail).
Immunosuppressants (e.g., azathioprine, cyclophosphamide): Used to suppress the immune system.
Folic acid: To support red blood cell production.
Blood transfusions: To temporarily increase red blood cell count in severe cases.
Is Communicable
No, WAIHA is not communicable. It is an autoimmune disorder and cannot be spread from person to person.
Precautions
Precautions for individuals with WAIHA focus on managing the condition and its complications:
Adherence to medication regimen: Follow prescribed medication schedule and dosage.
Regular medical follow-up: Regular monitoring by a healthcare professional.
Avoidance of triggers: If medication-induced, discontinue the offending drug.
Infection prevention: Take precautions to avoid infections.
Monitor for complications: Be aware of signs of worsening anemia, such as increased fatigue, shortness of breath, and chest pain.
How long does an outbreak last?
The duration of a WAIHA "outbreak" or episode varies significantly from person to person. It can range from weeks to months, or even become chronic. Treatment can help to shorten the duration and manage the condition. Relapses are possible, even after successful treatment.
How is it diagnosed?
Diagnosis typically involves:
Physical exam: To assess for signs of anemia and splenomegaly.
Complete blood count (CBC): To assess red blood cell count, hemoglobin, and hematocrit.
Peripheral blood smear: To examine the morphology of red blood cells.
Reticulocyte count: To assess the bone marrow's response to anemia.
Direct antiglobulin test (DAT) or Coombs test: To detect antibodies or complement proteins on the surface of red blood cells.
Indirect antiglobulin test: looks for unbound antibodies in blood stream
Other tests: To rule out other causes of anemia and identify underlying conditions (e.g., autoimmune diseases, infections, lymphoproliferative disorders).
Timeline of Symptoms
The onset and progression of symptoms can vary.
Initial Phase: Fatigue, weakness, and pallor may develop gradually or rapidly.
Progressive Phase: Jaundice, dark urine, shortness of breath, and dizziness may appear as anemia worsens.
Chronic Phase: If untreated or poorly controlled, symptoms can persist long-term with periods of exacerbation and remission.
Important Considerations
WAIHA can be life-threatening if severe and left untreated.
Treatment can be long-term and may require adjustments over time.
Management of underlying conditions is crucial.
Patients should be educated about the disease, its treatment, and potential complications.
Consultation with a hematologist (a doctor specializing in blood disorders) is essential.