Autoimmune Hemolytic Anemia
- Students vs. Pandemics
- Dec 22, 2025
- 3 min read
Written by Ariyan Darvish, Edited by Christopher LeBoa
Introduction
Hemolytic Anemia is an autoimmune disease where red blood cells are destroyed by the immune system at a rate faster than the body replaces them. This occurs when the body mistakenly recognizes blood cells as foreign substances and destroys them. The disease is rare, affecting one to two people per 100,000 people every year.1 AIHA can be classified as primary vs. secondary or warm vs. cold. AIHA is considered primary AIHA in the case when there are no other underlying conditions or secondary AIHA when it is caused by another condition. Warm AIHA accounts for most cases and happens when antibodies attack red blood cells at normal or above normal body temperatures. Cold AIHA is rare and happens when the same thing happens at cold body temperatures, usually in the presence of IgM antibodies which are usually the first immune cells to respond to an infection in the body.2
Causes
AIHA is often initiated by viral infections which can cause the immune system to malfunction and attack the body. Examples of these viruses include Measles, Mumps, and Rubella.1 These cases are almost always warm AIHA as these viruses usually cause fevers which raise body temperature. Autoimmune disorders like Lupus, Rheumatoid arthritis, and thyroid disease can make one more susceptible to AIHA as the body’s immune cells are more likely to attack blood cells. While viruses and autoimmune disorders can be attributed to half of AIHA cases, the other half of AIHA cases are idiopathic, or have unknown causes.3 In these cases it cannot be linked with other disorders and develops spontaneously. These cases are primary AIHA as there is no underlying condition causing it.
Diagnosis
One way to test for AIHA is a CBC or complete blood count test. This will measure the size and quantity of red blood cells, white blood cells, and platelets. A low amount of red blood cells and platelets or higher amounts of white blood cells may implicate AIHA. Another way to test for AIHA is a peripheral smear. This is where healthcare providers observe blood cells under a microscope to see if they are being destroyed. This method can often give a more definitive result than a CBC. Another method of testing for AIHA is using a Coombs’ test to determine if the immune system is creating antibodies in response to red blood cells. This is a procedure where a small blood sample is drawn and combined with a reagent that will make red blood cells clump together or agglutinate if there are antibodies attacking them. CBC is usually the test healthcare providers start with when facing blood disorders. If AIHA is suspected from the results, then a peripheral smear or Coomb’s test may be done which can actually confirm AIHA.1
Treatment
People with mild AIHA often do not need treatment, however patients with more severe AIHA need treatments such as medication or surgery. When AIHA is caused by an underlying condition, the other condition must be treated. For example, when one has AIHA due to the thyroid problem, the thyroid problem must be addressed to manage the AIHA. To treat primary AIHA, medications can be used to weaken the immune response to red blood cells keeping them alive and alleviating symptoms. Medications like Corticosteroids are used to weaken the body’s immune response which will lower the rate of red blood cells being killed and subdue symptoms. If medication is ineffective, surgery can be done to remove the spleen. The removal of the spleen ceases the production of antibodies that attack red blood cells.
References
1. What is autoimmune hemolytic anemia (AIHA)? Cleveland Clinic. November 19, 2025. Accessed November 24, 2025. https://my.clevelandclinic.org/health/diseases/22349-autoimmune-hemolytic-anemia#management-and-treatment.
2. Cherney K. Understanding warm and cold hemolytic anemia. Healthline. September 13, 2024. Accessed November 24, 2025. https://www.healthline.com/health/anemia/warm-vs-cold-hemolytic-anemia#key-differences.
3. Kaeberlein S. Autoimmune hemolytic anemia: Causes, diagnosis, and treatment options. AmeriPharma® Specialty Care. July 9, 2024. Accessed November 24, 2025. https://ameripharmaspecialty.com/other-health-conditions/autoimmune-hemolytic-anemia-causes-diagnosis-and-treatment-options/.
This post is not a substitute for professional advice. If you believe that you may be experiencing a medical emergency, please contact your primary care physician, or go to the nearest Emergency Room. Results from ongoing research are constantly evolving. This post contains information that was last updated in December 2025.
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