Autoimmune hemolytic anemia

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Autoimmune hemolytic anemia is a group of disorders characterized by a malfunction of the immune system that produces autoantibodies, which attack red blood cells as if they were substances foreign to the body.

Some people have no symptoms, and other people are tired, short of breath, and pale.
Severe disease may cause jaundice or abdominal discomfort and fullness due to splenomegaly (an enlarged spleen).
Blood tests are used to detect anemia and determine the cause of the autoimmune reaction.
Treatment is corticosteroids or other drugs that suppress the immune system and sometimes, splenectomy (surgical removal of the spleen).

(See also Overview of Anemia.)
Autoimmune hemolytic anemia is an uncommon group of disorders that can occur at any age. These disorders affect women more often than men. About half of the time, the cause of autoimmune hemolytic anemia cannot be determined (idiopathic autoimmune hemolytic anemia). Autoimmune hemolytic anemia can also be caused by or occur with another disorder, such as systemic lupus erythematosus (lupus) or a lymphoma, and it can be due to the use of certain drugs, such as penicillin.
Destruction of red blood cells by autoantibodies may occur suddenly, or it may develop gradually. If caused by a virus, the destruction may stop after a period of time. In other people, red blood cell destruction persists and becomes chronic. There are two main types of autoimmune hemolytic anemia:

Warm antibody hemolytic anemia: The autoantibodies attach to and destroy red blood cells at normal body temperature.
Cold antibody hemolytic anemia (cold agglutinin disease): The autoantibodies become most active and attack red blood cells only at temperatures well below normal body temperature.

Paroxysmal cold hemoglobinuria (Donath-Landsteiner syndrome) is a rare type of cold antibody hemolytic anemia. Destruction of red blood cells results from exposure to cold. Red blood cells may be destroyed even when cold exposure is limited to a small area of the body, such as when the person drinks cold water or washes hands in cold water. An antibody binds to red blood cells at low temperatures and causes destruction of red blood cells within arteries and veins after warming. It occurs most often after a viral illness or in otherwise healthy people, although it occurs in some people with syphilis. The severity and rapidity of development of the anemia varies.