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Autoimmune hemolytic anemia (AIHA)


What is autoimmune hemolytic anemia (AIHA)?

Autoimmune hemolytic anemia (aw-toe-ih-MEWN HEE-mah-lih-tik a-NEE-mee-a) is a disease of the immune system that causes red blood cells to break open or lyse (break down). The job of the immune system is to attack germs that are not supposed to be in your body. In AIHA, the immune system attacks the red blood cells by mistake and causes them to be destroyed in the blood vessels or in the spleen. This causes anemia (low red blood cell levels).

Why does this happen?

The cause of AIHA is not known. Some children may have a fever or infection a few days or weeks before developing AIHA. AIHA is not contagious and does not run in families.

What are the symptoms of AIHA?

When red blood cell levels are low, patients have anemia. Anemia can cause your child to look pale and have decreased energy, sleepiness, fast heartbeat, shortness of breath, or headache. As the red blood cells break down, some of the cell contents are changed into bilirubin (BIL ih roo bin). Jaundice (yellowing of the skin or eyes) occurs because of the increase in bilirubin. Jaundice may mean that the cells are breaking down more than they should. Bilirubin also causes the urine to become dark.

What is the treatment for AIHA?

The first choice of treatment for AIHA is steroids, which are taken by mouth. Some children may require a blood transfusion. In some cases, steroids do not work well, and other treatments are needed. These treatments may include medicines given in a vein (IV), or in rare cases, surgery to remove the spleen. The doctor will discuss these treatments with you if they are needed.

What are the side effects of treatment with steroids?

Steroids have different effects on different children. These are some possible side effects:

  • Stomach pain
  • Feeling more hungry than usual
  • Moodiness
  • Trouble sleeping
  • Flushing of the face
  • Weight gain, especially in the face and abdomen (belly)
  • Acne
  • Elevated blood pressure
  • Elevated blood sugar level
  • Increased risk of infection

Other medicines may be prescribed to prevent these side effects. Your doctor will gradually decrease the dose of the steroids until they can be stopped completely. The side effects go away when the steroids are stopped.

Will my child recover?

Most children only have AIHA for a few months. A few children will have AIHA that comes and goes over months to years. There is no way to know how quickly your child will recover from AIHA.

When should I call my doctor?

If your child looks pale, has increased jaundice, dark urine, or is more tired than usual, you should call the doctor. Your doctor might order a blood count test to see if the level of red blood cells has decreased or if the bilirubin level is increased.


If you have questions, talk to your child’s doctor or nurse. To learn more about AIHA, call the Hematology Clinic at 901-595-5041. If you have an urgent need and cannot reach the Hematology Clinic because it is after hours or a holiday, call the main St. Jude number, 901-595-3300, and ask to speak to the hematologist on call. If you are outside Memphis, dial toll-free 1-866-2STJUDE (1-866-278-5833).


This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).

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