Hemolytic anemia medical therapy

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Hemolytic anemia Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Shyam Patel [2]

Overview

Medical therapy focuses on immunosuppression. Typical treatment options include corticosteroids or non-steroidal immunosuppressants. Non-steroidal immunosuppressants include rituximab, azathioprine, mycophenolate mofetil, cyclophosphamide, and other agents. The advantage to the use of non-steroidal immunosuppressants is that patients can be spared of adverse effects of steroids like bone loss, cataracts, and glaucoma.

Medical Therapy

The goal of medical therapy for hemolytic anemia involves correction of the underlying pathophysiology. In most cases, the cause of hemolytic is due to abnormal immune activation, resulting in antibody production against red blood cells.[1] Immunosuppression is a mainstay of treatment for hemolytic anemia that is caused by alloimmunization.[1] For non-immune-related hemolytic anemia, elimination of the precipitant is the most important aspect of treatment. Supportive care, such as packed red blood cell transfusions, can serve as a temporizing measure but will not alter the disease course or address the underlying pathophysiology.

Medications

Supportive Interventions

References

  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 Salama A (2015). "Treatment Options for Primary Autoimmune Hemolytic Anemia: A Short Comprehensive Review". Transfus Med Hemother. 42 (5): 294–301. doi:10.1159/000438731. PMC 4678315. PMID 26696797.
  2. Zanella A, Barcellini W (2014). "Treatment of autoimmune hemolytic anemias". Haematologica. 99 (10): 1547–54. doi:10.3324/haematol.2014.114561. PMC 4181250. PMID 25271314.
  3. Piek CJ, van Spil WE, Junius G, Dekker A (2011). "Lack of evidence of a beneficial effect of azathioprine in dogs treated with prednisolone for idiopathic immune-mediated hemolytic anemia: a retrospective cohort study". BMC Vet Res. 7: 15. doi:10.1186/1746-6148-7-15. PMC 3096914. PMID 21489250.
  4. Farruggia P, Macaluso A, Tropia S, Genova S, Paolicchi O, Di Marco F; et al. (2011). "Effectiveness of cyclosporine and mycophenolate mofetil in a child with refractory evans syndrome". Pediatr Rep. 3 (2): e15. doi:10.4081/pr.2011.e15. PMC 3133497. PMID 21772952.

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