Using Steroids to Treat Immune Hemolytic Anemia
Hemolytic anemia is a condition wherein the red blood cells (RBC) are broken down or destroyed in the blood vessels or in other parts of the body. When the breakdown of RBC becomes faster, the body produces more RBC to make up for the loss. When the rate at which the body breaks down RBC exceeds that rate at which the body produces RBC, anemia is then experienced.
Immune hemolytic anemia is a kind of hemolytic anemia characterized by the immune system’s early destruction of red blood cells. This condition involves the formation of antibodies that target the body’s own red blood cells.
The antibodies detect the red blood cells as foreign material and destroy them. The body may obtain these antibodies through various means, such as by blood transfusion, complications arising from a disease, and a baby having a different blood type from its mother. These antibodies may also result from negative reaction to medicines.
When the antibodies form because of disease complications or reaction to medicines, the condition is called secondary immune hemolytic anemia. Sometimes, the cause of the formation of antibodies could not be determined. An example of such case is idiopathic autoimmune hemolytic anemia. This constitutes about half of the immune hemolytic anemias known.
Immune hemolytic anemia can quickly develop and progress rapidly even at the onset. However, in some cases, it continues to be mild, thus not necessitating special treatment.
The symptoms of immune hemolytic anemia include pale or yellowish skin color, tiredness or fatigue, fast heartbeat or heart rate, shortness of breath, enlarged spleen, and dark urine. The disease is diagnosed by performing several tests. The following indicate that the patient is suffering from the disease: Coombs’ test turning out positive direct or indirect; increased bilirubin levels; increased LDH level (LDH are enzymes that increase when the body is experiencing tissue damage); presence of hemoglobin in the urine; decreased serum haptoglobin level; increased reticulocyte count; and decreased hemoglobin and RBC count.
The first defense against this disease is treatment with steroids, specifically prednisone, during therapy. Prednisone is a corticosteroid that is synthetically produced. Corticosteroid is a kind of steroid that the adrenal cortex naturally produces. Corticosteroids have a wide range of physiological applications. They are used to treat conditions like skin diseases, adrenal problems, brain tumors, and others.
There are generally two classes of corticosteroids – glucocorticoids and mineralocorticoids. Glucocorticoids act as anti-inflammatory agents, and they also control the metabolism of fats, carbohydrates, and protein. Mineralocorticoids control the levels of water and electrolytes in the body.
Prednisone possesses both glucocorticoid and mineralocorticoid properties and effect. It is generally used as an immunosuppressant; the mechanism of prednisone in fighting immune hemolytic anemia is to suppress the immune system. In most cases, administering prednisone to the patient is enough to help control the anemia effectively, either completely or partially.
One should exercise caution in giving blood transfusions to persons suffering from immune hemolytic anemia. If an incompatible blood type is given, the body might react more negatively and worsen the disease. If blood transfusion should be necessary, the blood should be screened for antibodies.