Autoimmune hemolitic anemia
Hemolitic anemias represent set of both inborn, and acquired diseases which are characterized by destruction of erythrocytes in cells or in vessels. Autoimmune hemolitic anemias (in abbreviated form AHA) – the most often found kind of hemolitic anemias.
Autoimmune hemolitic anemia: etiology, pathogeny, classification and clinical picture
Hemolitic anemia can develop owing to the conflict of a blood group or a Rhesus factor between mother and a fruit or owing to transfusion of donor blood. Them call isoimmune.
Carry cases when own immune system develops antibodies to own erythrocytes to the second group. They are called autoimmune hemolitic anemias. When performing diagnostic blood test at patients about AHA IgG immunoglobulins (IgM and IgA is rare) show an aberration.
In most cases autoimmune hemolitic anemias meet in the form of various specific and nonspecific symptoms against the background of other diseases of blood; can proceed both in an acute form, and in the form of chronic process.
In acute cases the disease begins with weakness, an asthma and heartbeat, temperature increases, vomiting and jaundice, pains in heart and in a waist are noted.
Chronic autoimmune hemolitic anemia often proceeds almost asymptomatically with periodic aggravations. Against the background of remission note increase in a liver and spleen at a palpation, quite often jaundice.
In the developed blood test at patients AHA note, in particular, the normal or raised hemoglobin, increase in SOE, normal level of thrombocytes. In an acute form and at aggravations of a chronic current the quantity of leukocytes whereas their level is in a remission stage normal increases.
The diagnosis "autoimmune hemolitic anemia" most often is more precisely differentiated by specialists after conducting specific diagnostic testings.
Kinds of treatment of autoimmune hemolitic anemias
Tactics of treatment of autoimmune hemolitic anemia at the acute course of a disease or an aggravation of chronic process without fail includes hormonal therapy. The average daily dose of Prednisolonum of 60-80 mg is divided into three receptions in the ratio 3:2:1. In case of inefficiency of treatment it can be increased to 150 mg and above, and in process of improvement of a condition of the patient – gradually decreases (by 2,5-5 mg a day with the purpose to avoid a recurrence) at first to a half of an initial dosage and further up to full drug withdrawal.
At chronic disease, treatment of autoimmune hemolitic anemia demands purpose of Prednisolonum, but in a daily dose of 20-25 mg. Administration of drug is carried out under laboratory control, and in process of normalization of indicators of blood its dose smoothly decreases to supporting - 5-10 mg a day.
Sometimes and justified in therapy also purpose of drugs from group of immunodepressants AHA is reasonable, and at heavy hemolitic crises infusional therapy is shown: individually picked up packed red cells, Haemodesum, etc. for intoxication. Sometimes pour a blood plasma, the washed or frozen erythrocytes, resort to a hemodialysis method (an artificial kidney) and a prazmofereza (removal of a liquid part of blood – plasma – together with antibodies).
A number of patients AHA differs in the increased resistance to effect of hormonal drugs. Disease is characterized at them by a frequent recurrence and practically does not give in to medicamentous correction. AHA at this category of patients apply radical treatment to treatment – a splenectomy (removal of a spleen) which considerably improves quality of life.
Despite the highest level of development of modern medicine treatment of hemolitic anemias is very difficult, and the diagnosis quite often adverse.
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