The first treatment tried is usually a steroid medication, such as prednisone. If steroid medications do not improve the condition, treatment with intravenous immunoglobulin (IVIG) or removal of the spleen (splenectomy) may be considered.
You may receive treatment to suppress your immune system if you do not respond to steroids and splenectomy. Medications such as azathioprine (Imuran), cyclophosphamide (Cytoxan), and rituximab (Rituxan) have been used.
Blood transfusions are given with caution, because the blood may not be compatible and it may cause more red blood cell destruction.
The disease may start quickly and be very serious, or it may remain mild and not need specific treatment.
In most people, steroids or splenectomy can control anemia. In others, treatment can usually partially control the anemia.
Severe anemia rarely leads to death. Severe infection may occur as a complication of treatment with steroids, other medications that suppress the immune system, or splenectomy, because these treatments impair the body's ability to fight infection.
Calling your health care provider
Call your health care provider if you have unexplained fatigue or chest pain, or signs of infection.
Screening for antibodies in donated blood and in the recipient may prevent hemolytic anemia related to blood transfusions.
Powers A, Silberstein LE. Autoimmune hemolytic anemia. In: Hoffman R, Benz Ej, Shattil SS, et al, eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 47.
Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.